HomeMy Public PortalAbout4831 GLICKMAN AVE_Plumbing__ A667
DBS-17 f0-55' APPLICATION FOR PLUMBING PERMIT
DBS-17 7
DIVISION OF BUILDING AND SAFETY =' 1
Depaxtment of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN I NEAREST
^ - CROSS ST.
OWNER /91,Q.c�y ` DISTRICT NO. GRO P4tE READY FOR INSPECTION
MAIL ADDRESS "
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER ' ctzX W - INSPECTION RECORD
ADDRESS 1,4 D t.�P •,
CITY ` TEL. NOb., 1
6 1
LICENSE NO. — c(i
NUMBER TYPE OF FIXTURE OR ITEM FEE
` WATER CLOSET (TOILET) @ $1.00 $ /
f BATH TUB @ $1.00
SHOWER @ $1.00
l LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK /,,
PERMIT $ 00 ROUGH PLUMBING Frs [�2R
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE
OF PERMITTEE "'' v_ FINAL
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. II.O. CASH
o 4 4- t' Y-7 3 * �I
76A667-CE9817 6-65
APPLICATION FOR PLUMBI G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS `�
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY `
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
SATE LIC
LAUNDRY TUB 1.25 LICENSE NO. CLASS
CLOTHES WASHER 1.25 DISC CT O. G P ZONE P O BY
WATER HEAklwe�
1.50 t
1.50 INDUSTRIAL }
f
GAS SYSTEM OUTLETS WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD O
O
u
W
I CL
z
I
I
I
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 5 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
L
MBING.HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
ENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TOGAS TEST
IDE IN,THE ABOVE DESCRIBED RESIDENTIAL P OP RTY. UTiLITY CO.NOTIFIED
NATURE
F PERMITTEE ---LLL FINAL
ALIDATION
/ CK. M.O. CASH
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