HomeMy Public PortalAbout5927-29 IVAR AVE_Plumbing__ 76 A 667V—CE 817 468
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER G
Y
BUILDING AND SAFETY DWISION BUILDING
`� 02
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) . NEAREST
CROSS ST. �'J2
o NUMBER FIXTURE OR ITEM EACH FEE -
OWNER ��G/ /✓/
WATER CLOSET 1.50 �(.�
MAIL
BATH TUB 1.50 ADDRESS S
/ SHOWER - 1.50 CITY 7 25-1yfPLL e/r>l'EL. NO.ftT7.j/'1r�
LAVATORY 1.50 .V CONTRACTOR
SINK 1;50 ADDRESS
DISHWASHER 1.50 CITY TEL. NO.
CLOTHESWASHER1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00 r
WATER HEATER 1.50 - INDUSTRIAL L u
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTIO RECORD O
OUTLETS OVER
5 PER SYSTEM .30
/ d
N
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE '$ 2 00
TOTAL FEE 3�U a
APPROVALS - DATE IN ECTOR'S IGNATURE
Plan check applicant may- 'n a UNDER SLAB WORK
Name , ��L/ /7- ROUGH PLUMBING �•
Address �C GAS PIPING
GAS VENT -
City /s�yj>j>LL� �7-� Tel. No. �j.? r 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.
I 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
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PRR7RTY. FINAL
SIGNATURE +� .L ls�sSACK R. ALLEN, SUPERVISING CH ANIC AL ENU'R'
OF PERMITTE
PERMIT VALIDATION cI, M.O. CASH.
PIAN CHECK VALIDATION CK. M.0. CASH