HomeMy Public PortalAbout4836 GLICKMAN AVE_Plumbing__ 76A667-CE#817 10-62
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES ~,_
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONBUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN CNEAREST
ROSS ST. 24
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
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑
REGISTRATION NO. �S COUNTY ❑
JCLOTHES WASHER 1.25 DISTRICT NO. G OFU-P ZONE P OCESSED BY
WATER HEATER 1.50 - L5
i
GAS SYSTEM 1.50 INDUSTRIAL OUTLETS WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD V
iz O
APPROVALS A E INSPECT9R'S SIQNATU'
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
PLUTH ALL MBING.NG, COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES - A
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 'f"•
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERM ITTE FINAL >•
M
ALIDATION ROBERT A. WOOD
CK. M. 0. CASH SUPERVISING MECHANICAL ENG'R
Lys