HomeMy Public PortalAbout6215 ENCINITA AVE_Plumbing__ 7SA607-CE817 10-§0
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER _ - --
BUILDING AND SAFETY DIVISION RonDING
JOHN A. L.AMBIE. COUNTY ENGINEER ADD8ES3 i
WILLIAM A. JENSEN, SUPT OF BUILDING f
LOCALITY �
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSE[ MAIL
BATH TOB ADDRESS
CITY NO.
SHOWER
LAVATORY CONTRACTOR
sin ADDRESS /
DISHWASHER CITY > / TEL No. 03s i..
CONTRA R' STATE
LAUNDRY TUB REGISTRATION NO. 6 COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZONE P OCES D BY
WATER HEATER 4
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL >-
i
/: INSPECTION RECORD- /�',n.L- d—
i/7.�/6 �0
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a $1.00 PER REM
D -OR FIXTURE S O •DATE- INSPECTOR'S SIGNATURE
.PERMIT S 2100 UNDER 49iB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPINGI I
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
i LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST l'✓�ID�/
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE ,
DESCRIBED RESIDENTIAL PROPERTY UTILITY 00. NOTIFIED
SIGNATURE
OF PERMITTE _ ` FINAL
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APPLICATION FOR P UMBING PERMIT
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BUILDING AND SAFETY DIVISION
FOR APPLICANT 70FILL INIPRINTORiYPEI BUILDING �.�
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCALITY TE�i(11 c� G
NEAREST
BATH TUB
CROSSNEAREST
Si. l.!
SHOWER OWNER A) GC19
LAVATORY MAIL yh -
ADDRESS 1 I
SINK CITY TEL.NO
DISHWASHER CONTR T
i IC CLOTHES WASHER - -'
ADDRE �. � �
SWIMMING POOL RECEPTOR
CITY ✓20 E. 1
Its
LAWN SPRINKLER SYSTEM
STATE
WATER HEATER U LICENSE NO. CLASS
GAS SYSTEM OUTLETS DISTRICT NO. GROUP JE P CES$ 8V Y
OUTLETS OVER Y
5 PER SYSTEM INDUSTRIAL G
WASTE APPROVAL V
INSPECTION RECORD a
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W
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N
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Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE S
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
� UNDER SLAB WORK '
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
HEREBY ACKNOWLEOGE THAT I HAVE READ THI5 APPLICATION AND STATE GASVENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE y /- �
OF PERMITTEE �/ FINAL
PLAN CHECK VALDAT eH— PERMIT VALIDATION CK: M.o. CASH
`POLICY HOLDERfdf 24.r R 5 2 3-=DEC 7 5 D 7,5 0 a -,
POLICY NUMBER: o 3 i6R °a
j) YE'�