HomeMy Public PortalAbout6321 ENCINITA AVE_Plumbing__ ]fiA6fi] ICE-el]ABPPLICATIO FOR, PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILOI NG I F
ADDRESS i
HARVEY T. BRANDT, COUNTY ENGINEER n
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPEI NEAREST
CROSS ST..•- -
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1,75
MAIL.
BATH TUB 1.75 ADDRESS 3
SHOWER 1.75 CITY TEL NO. G— p
LAVATORY 1,75 CONTRACTOR
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY TEL. NO.
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO. ' CLASS
SWIMMING POOL RECEPTOR 1.75
OIS_T_RICT NO, 7P F O ES�SED BY
LAWN SPRINKLER SYSTEM 1.75 8
WATER HEATER 1.75 INDUSTRIAL _-
WASTEAPPROVAL y
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER 30
5 PER SYSTEM
0
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Plan Check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS GATE nls Pec TO R'e sISNATune
Plan chEEQk applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City 'Tel. 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 LAW S REGULATING
PLUMBING. GAS TEST
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LI CEN SEB AS REOUIRE0 BY ED ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIB D RESIDE IAL PROP TY.
FINAL
SIGNATURE 55 •/•/��JJ��//�� f
OF PERM(T T EE�i'� /7��A� PERMIT VALIDATION
CK. M. CASH
PLAN CHECK VALIDATION CK. M.D. CASH '
� �/ �GGi 8 5 0 650ea