HomeMy Public PortalAbout5325 GOLDEN WEST AVE_Plumbing__ 76168
SCE 817 8--58 Y A LIClr,TION FOR PLUMBING PERMIT
BUILDING AND SAFETY DMSION
Department of County Engineer
County of Los Angeles rU
LDING
JOHN A. LAMBIE,COUNTY ENGINEER RESSCASSATT D GRIFFIN,SUPT OF BUILDINGALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER t L
DISTRICT NO. GRQLB, I ZONE I READY FOR INSPECTION
MAIL
ADDRESS 15
INDUSTRIAL
CITY TEL. N0. WASTE APPROVAL
PLUMBER INSPE TION RECORD
ADDRESS
CITY EL. NO.
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $100
/ BATH TUB @ $1.00
p SHOWER @ $1.00 '+�,�
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $100
DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $100
WATER HEATER @ $100
GAS SYSTEM @ $1.00 r
APPROVALS
DATE INSPE f, GNATURE
UNDER SLAB WORK
PERMIT $ I 1 00 ROUGH PLUMBING l
GAS PIPING
TOTAL FEE Gas VENT
I D HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES Q
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST pJJ—V
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 FINAL
ROBERT A.WOOD,
JOHN A LAMBIE. COUNTY ENGINEER VALIDATION SUPERVISING MECHANICALENG'R
CK. N.0. CASH
,a4192-,,-; NOV 12 3 10.00