HomeMy Public PortalAbout5940 1/2 GOLDEN WEST AVE_Plumbing__ 76 A 667—CE 817 8/68 I
APPLICATION FOR PLUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION BUILDING
s
JOHN A. L"AMBIE. COUNTY ENGINEER
COLEMAN•W JENKINS SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50
�y /
BATH TUB 1.50 MAIL ADD 7
SHOWER 1.50 CITY — TEL. NO.
LAVATORY 1 so CONTRACTOR
SINK 1 50 ADDRESS
DISHWASHER 1.50 CITY 7 TEL. NO,� '
ZO6-3.
CLOTHES WASHER 1 50` STATELIC
LICENSE NO �r�/D CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT GROUP ZONE I PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00
O
WATER HEATER 1 50 INDUSTRIAL U
WASTE APPROVAL Z
0
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD 2
OUTLETS OVER �y / Lu
V
5 PER SYSTEM 30 �`�` N
Z
Plan check fee 25% of above See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan Cheek applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel No
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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 I AM THE LEGAL OWNER OF,AND INTEND TO 41
RESIDE IN, THE ABOVE DESCRIBEDR SIDENTIAL PROPERTY FINAL
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL R
OF PERM ITTE
PERMIT VALIDATION CK M o ASHD
PLAN CHECK VALIDATION CK M 0 CASH