HomeMy Public PortalAbout4828 GLICKMAN AVE_Plumbing__ 78A887-GE#817 10.82
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 4,g-
WILLIAM
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WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
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FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25 /
MAIL
BATH TUB 1.25 2) ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 2 t CONTRACTOR
SIN% 1.25 27 ADDRESS �-1
DISHWASHER 1.25 CITY TEL. NO.
CONTRACTOR'S STATE
LAUNDRY TUB 1.25 REGISTRATION NO. �( l ( COUNTY ❑
j CLOTHES WASHER 1.25 f
DISTRICT GRO ONE P SSED BY
/ WATER HEATER 1.50
GAS SYSTEM OUTLETS 1.50 f 3 INDUSTRIAL d
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
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APPROVALS A INSPECTOR'S SIGN UR .
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
D
ANSTATE THAT T R
THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
WATER HEAT
PLUMBING. HOT W ER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED Y LOS ANGELES COUNTY AND STATE OF GAS TEST /
CALIFORNIA OR THAT I,A THE"LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE�ES RILR ESIDENTT7.L PROPERTY. UTILITY CO. NOTIFIED •L3�
SIGNATURE
OF PERMITTEE L� -7
FINAL
V LIDATION ROBERT A. WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
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6 A 667 - CE 817 7-69
'3GWI* city $38088
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER'
BUILDING AND SAFETY DIVISION ADDRESS 4858 Glic�►n
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY TqW10 Cit
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST. d
NUMBER FIXTURE OR ITEM EACH FEE *
OWNERlie i
WATER CLOSET 1.50 MAIL y�.�,�
BATH TUB 1.50 ADDRESS 4828 lickwnn
SHOWER 1.50 CITYM@MldkTEL. NO.
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00o
'r� •'"� �' a`y r•
1 WATER HEATER 1.50 l BO WINDUSTRIAL
WASTE APPROVAL O
GAS SYSTEM OUTLETS 1.50 , INSP%CTION RECORD V
OUTLETSOVER
A aw W
5 PER SYSTEM •30 J
LL
Q
O
a
Pl'�n check fee 25% of above. See reverse. H
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE 3150
APPROVALS DATE INSPECTOR'S SIGNATURE
I Plan check applicant UNDER SLAB WORK
I
Name, ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City I Tel. No.
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 REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGA OWNER OF,AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RE7N P RTv. FINAL
I SIGNATURE JACK R. ALLEN, SUPERVISIN G"MECHANI CAL ENG-R.
l OF PERMITTEE /
l PERMIT VALIDATION! C K.,,., M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CAS; r� ':�!`'