HomeMy Public PortalAbout5723 ENCINITA AVE_Plumbing__ ]SAGGT IcE-Bnl - 1/75 V •• A
APPLICATION FOR" PLUMBING, PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER / O
BUILDING AND SAFETY DIVISIONNG
_ �6
MAKE CHECKS PAYABLE TO: - - FLOOCA
DDRE55 S 713NG A %'� 'HARVEY T. BRANDT, COUNTY ENGINEER' LIT,
( tip
FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEAREST
CROSS ST. . !/L
NUMBER ' FIXTURE OR ITEM @ FEE
2.00 .OWNER'
WATER CLOSET -
MAIL �•. ,.f -
BATH TUB 2.00 - ADDRESS
SHOWER 2.00 ''CITY T,,E//L..NO. ,X7/. l7C _
LAVATORY 2.00 CONTRACTOR x,57 !`61/ ' I G--
SINK 2.00' ADDRESS ?�:? 1 L/ L tl u• !\�
DISHWASHER , 2.00 CITYi' TEL.-NO. )
CLOTHES WASHER ' 2.00, ..STATE -p LIC -
LICENSE NO. "r ^�ALI - CLASS, C `7-G
SWIMMING POOL RECEPTOR 2,00 l
DISTRICT NO.GROUP ZONE !PR CESSED-B `
LAWN SPRINKLER SYSTEM 2,00. ,�"• ' V •�
...J. L� �.. —"l
WATER HEATER2.00 INDUSTRIAL U -
WASTE APPROVAL j
GAS SYSTEM' OUTLETS 2.00 INSPECTION RECORD
OUTLETS OVER - ,30
5 PER SYSTEM • - -
d
- yJ
H
.Plan Check fee SOB Revere
PLUMBING PERMIT ISSUING FEE $ '3' 00 -
TOTAL75 -
'APPROVALS DATE. INGPEOTOR•G GIGNATURE
Plan check applicant - UNDER SLAB.WORK - - -
Name y HOUGH PLUMBING -
Address GAS PIPING
CityTCI. No. 'GAS VENT ,
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ
.THIS APPLICATION - - _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING_FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING. -
I HEREBY CERTIFY THAT I,AM PROPERLY'Rf GISTE REO AND/OR UTILITY CO. NOTIFIED
LICENSED AS REOU I RED By LOS ANGELES COUNTY AND.STATE OFA
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, ANO INTEND TO
RESIDE IN THE ABOVE'DESCRIBED RE5IDENTIA4 PROPERTY. FINAL '-
SIGNATURE
GF PERMI T:f-EE� �+F�"-" + -�•'4T/ PERMITVALIDATION
/-CK. `LLOICASH
PLAN CHECK VALIDATION CK. M.D. CASK