HomeMy Public PortalAbout5456 LOMA AVE_Plumbing__ 76A667; CE817 V70 - - -
' APPLICATION FOR PLUMBING . PER T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING //
BUILDING AND SAFETY DIVISION ADDRESS.... (� �7
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS SUP T OF BUILDING LOCALITY r
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS-ST. C�3
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50 _
MAIL
BATH TUB 1 50 ADDRESS -
SHOWER 1.50 CITY _ TEL. NO�OIJ� 3--
LAVATORY.' 1.5 0
CONTRACTOR' ���
SINK 1.50 ADDRESS G
DISHWH
ASER 1.50 CITY - TEL.
CLOTHES WASHER 1.50 STATELIC
LICENSE-NO CLASSC
SWIMMING POOL RECEPTOR 1.50 - RICHT ,GROUP ZO P S BY
LAWN SPRINKLER SYSTEM 2.00 /V')
WATER HEATER 1.50 - WASTE APPROVAL,
GAS,SYSTEM OUTLETS 1.50 - ' ,INSPECTION RECORD
OUTLETS OVER _
5 PER SYSTEM '3 R Z
01 0
W
Z
Plan check-fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 00
TOTAL FEE7 "APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDERiSLAB WORK
Name - ROUGH PLUMBING '
Address GAS PIPING
GAS VENT -
City Tel. No HOT WATER HEATER-
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ,
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBINGFIXTURES-
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST-
PLUMBING _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTER D OR UTILITY CO NOTIFIED
LICENSED AB,REQUIRED BY L08 ANGELES COUNTY D STAT OF _ I
CALIFORNIA OR THAT I AM THE LEGAL OWNER O D INT D TO
RESIDE IN,THE ABOVj;jjZIDE NTIAL P ERTY. FINAL
SIGNATURE �.JACK-R.-ALLEN, SUP RVISI
OF PERMITTEE NG MECHANIC L ENG'R
- - -
,,PERMIT VALIDATION . CK M o CASH
PLAN CHECK V ATION CK MO CASH l ,
bto a 5 �.r ,r Eta ' -5 D 47'5-