HomeMy Public PortalAbout5471 GOLDEN WEST AVE_Plumbing__ 76 A 667—CE 817 8/68 �'y
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES ,
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION f
DR _r,� ��a
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING CALITY�7M p�E''/��
n FOR APPLICANT TO FILL IN(PR NT OR TYPE) F sT /�40c�A
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 1.50
BATH TUB .50 �
ADDRESS /I'. (�6L J��,V WeS7
1
SHOWER 1.50 CITY TEL. NO.
LAVATORY 1 50 CONTRACTORS'
SINK 1 50 ADDRESS 0 L7 7 �, 61e6pn D
DISHWASHER 1 50 CITY J G777P L> f TEL. NO.
CLOTHES WASHER 1 50 STATE / / LIC
LICENSE NO 7 / CLASS
SWIMMING POOL RECEPTOR 1 50 DISTRICT NO. GRO ZON PR S D BY
LAWN SPRINKLER SYSTEM 2 00 _a O
` WATER HEATER 1 50 ��(.� INDUSTRIAL V
WASTE APPROVAL Zo
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD F-
OUTLETS OVER
U
5 PER SYSTEM 30 d
N
Z
Plan check fee 2ri% of above. See reverse.
PLUMBING PERMIT ISSUING FEE: $ 2 00
TOTAL FEE 3510
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
IH
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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL f l
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R
OF PERMITTEE
PERMIT VALIDATION �. M o CASH
PLAN CHECK VALIDATION CK M O CASH '�-/
1/u