HomeMy Public PortalAbout6024 HART AVE_Plumbing__ 76A667-CE4817 4-67
APPLICAT�ON FOR PLUMfBNG PER:rlT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING b
JOHN A. LAMBIE• COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING' LOCALITY —� C
FOR APPLICANT TO FILL IN 3 NEAREST '
NUMBER FIXTURE OR ITEM EACH FEE cross sr.
OWNEF
WATER CLOSET $1.25 s- MAIL
BATH TUB 1.25 0 CITY TEL. NO.•ADDRESS
^
SHOWER 1.25 ��L�
LAVATORY 1.25 J -CONTRACTORS
SINK 1.25 ADDRESS ;•6-5 22,
DISHWASHER 1.25 CITY TEL.STATE LIC
LAUNDRY TUB 1.25 LICENSE NO. CLASS C-3
CLOTHES WASHER 1.25 y� DISTRICT NO.--.,- G ZONE P E BYOP
WATER HEATER 1.50 S D cam/ e
GAS SYSTEM__OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD a
CD
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It CD
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APPROVALS A DATE INSP R'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK / 41
ROUGH PLUMBING
TOTAL FEE
CAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT '41
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, 0 THE ABOVE CRI RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE42
OF PERMITTEE
FINAL lb
VALIDATION JACK R. ALLEN
CK.
M.0. CASH SUPERVISING MECHANICAL ENG'R.
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