HomeMy Public PortalAbout5520 GLICKMAN AVE_Plumbing__ 76•A 667 - CE 817 7-69
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APPLICATION FOR PLUMBING PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION rNEAREST
DING ff�JOHN A. LAMBIE, COUNTY ENGINEERESSCOLEMAN W. JENKINS. SUPT. of BUILDING ALITYFOR APPLICANT TO FILL IN(PR NT OTYPE) SS ST. /NUMBER FIXTURE OR ITEM EACH FEE ER @' 2'417 !� -�
WATER CLOSET 1.50 MAIL 67`', "uofilw ®/L 6-1p Q C.}
BATH TUB 1.50 ADDRESS [ —1
SHOWER1.50 CITY c.Gn f H TRKB.�RG`TEL. NO.,,
LAVATORY 1.50 CONTRACTOR AAo,q , 4 P4 �L
SINK 1.50 ADDRESS I �d S� /� A MCu 810 51
DISHWASHER 1.50 CITY P 'A W2DGWV7' TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO i GROUP ZONE P E D
LAWN SPRINKLER SYSTEM 2.00 ,-LJ-^ I It,J(/ / 1-- .
WATER HEATER 1.50 INDUSTRIAL o
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD u
OUTLETS OVER 30 O
5 PER SYSTEM
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Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City, 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,
1 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 LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DFrCRI ESIDENTI PROPERTY. FINAL
SIGNATURE JACK R. ALLEN, SUPERVISI M +I ANICAL EN'G'R.
OF PERMITTE A
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VA IDATION CK. M.0. CASH
6 5 5#'V-:3- NGV 7 5 D 4,0 0N