HomeMy Public PortalAbout5843 1/2 KAUFFMAN AVE_Plumbing__ 76 A 667 - CE 817 7769
APPLICATION . FOR PLUMB NG PER T .
�.. COUNTY OF LOS ANGELES
DEPARTMENT-OF COUNTY ENGINEER BUILDING Q- j
BUILDING AND SAFETY,DIVISION ADDRESS Q d7
r" JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS..SUP'T. OF BUILDING LOCALITY
FOR-APPLICANT TO FILL IN (PR NT•OR TYPE) NEAREST
CROSS ST. .�
NUMBER FIXTURE"OR ITEM EACH FEE
OWNEA
WATER CLOSET 1.50 '
MAIL
BATH TUB 1.50 ADDRESS ,
SHOWER 1.50 CITY`, TEL. NO J%-3
LAVATORY ,1.50' CONTRA OR
•SINK 1.50 ADDRESS '° t
DISHWASHER - 1.50 CITY - TEL NO. Al
CLOTHES-WASHER 1.50 STATE ,LIC
LICENSE NO ; _ CLASS
SWIMMING POOL RECEPTOR, 1.50 '-DIST ICT GTP ZONE PRO ES BY
LAWN SPRINKLER SYSTEM' - 2.00,
WATER HEATER . 1.50Y�v INDUSSWAST�pA AOVAL O
GAS SYSTEM OUTLETS 1.50 INSPECTION RD
OUTLETS OVER •
5 PER SYSTEM' _ .30 U /
0-
- Y z
Plan check"
fee 25% of above: See reverse.
PLUMBING PERMIT ISSUING,FEE $- 2 00
TOTAL FEE
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
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 1 AM PROPERLY REGISTERED' AND/OR UTILITY'CO. NOTIFIED
LICENSED.AS REQUIRED,BY.LOS ANGELES COUNTY AND STATE OF
CALIFO�RNIA OR THAT I A THE LEGAL OWNER OF,AND INTEND-TO
RESIDE IN,THE ABOVE DE RIB RESIDENTIAL PROPERTY.' FINAL ' '
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL E R.
OF PERMITTEE PERMIT VALIDATION CK -M O.
PLAN CHECK VALIDATION c'K. M.-o. CASH
1 K
!;Ar,'..d.'8., C- MR 3 ,o :5 5 0 '.
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