HomeMy Public PortalAbout5325 GLICKMAN AVE_Plumbing__r 76A667-CE1817 6-65
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS r
COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY
r
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 21.25 --
OWNERVdAz' -U
MAIL
BATH TUB 1.25 ADDRESS s
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 CONTRACTOR M w p
SINK 1.25 ADDRESS (Q
DISHWASHER 1.2S CITY M, P. TEL. NO. j 13_� Dg
STATEX-LZ
LIC /
LAUNDRY TUB 1.25 LICENSE NO. CLASS 0,3,b
CLOTHES WASHER 1.25 DISTRICT NO. E P ESSED BY
WATER HEATER 1.50 (Q'� I TLC
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GAS SYSTEM OUTLETS 1.50 INDUSTRIAL }
WASTE APPROVAL O_
OUTLETS OVER S PER SYSTEM .30 )f INSPECTION RECORD O
O_
N
Z
s
AP LS DATE INSPECTOR'S SI URE
PERMIT $ 2 00 UNDER WORK %
1) ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LIGATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED "
SIGNATURE /
OF PERMITTEE
FINAL
-�V LIDATION
CK. M.O. CASH
8 0 7 a DEC 15 5 D 7.25- V