HomeMy Public PortalAbout5807, 5807 1/4, 5807 1/2 ENCINITA AVE_Plumbing__ 76 -CE61710-W - -
APPLICATION FOR PLUMBING PERM1
COUNTY OF LOS ANGELES �.
DEPARTMENT OF COUNTY ENGINEER
BUILDING AN DESCFETY DIVISIONOUNTY BUILDING
DI
WILLIAM A. JENSEN, SUPT OF BUILDING
ALITY l
i
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. 1
NUMBER FIXTURE OR ITEM �9 OWNER ,
WATER CLOSES vL
BATH TUB ADDRESS
CITY TEL. NO.
SHOWER
LAVATORY 1 CONTRACTOR ,'
SING
DISHWASHER CITY ftI �'' iA, TEL. NO' ��✓ `,
CONTBACTOR'SSTATEp
LAUNDRY TUB REGISTRATION NO. "ZZ 5—ill COUNTY B
` CLOTHES WASHER `7 DI, STRIC Nom. GRO E RO SB BY
•� WATER HEATER 5 I .
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GAS SYSTEM INDUSTRIAL
WASTE APPROVAL' }
-7 / INSPECTION RECORD / 0
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M71147,
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17 V
vi*woC _ I� IrSGC 9 y'�J
® 51.00 PER ITEM !I� , ,A
OR FIXTURE $ pOVALS DATEI
INSPECTOR'S SIGNATURE
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PERMIT $ 2 1 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING19
'
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 1CORRECT AND AGREE COMPLY GAS VENT I
WITX ALL COUNTY ORDINANCES
S ANO STATE LAWS REGULATING HOT WATER HEATER / /
PIUMDING. ' /
4---
I
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE-
DESCRIBED RESIDENTIAL PROPERTY. , UTILITY CO. NOTIFIED
SIGNATURE f.�/ y
OF PERMITTEE _ FINAL ll /F
VALIDATION ROBERT A. WOOD
cN. M.D. CASH SUPERVISING MECHANICAL ENG-R
LACO'2 1 1 2-- JUL25_ 5 D 2 0.75- Q