HomeMy Public PortalAbout6222 LOMA AVE_Plumbing__ 76A667-CEn817 6-66 _5`908 \ '
APPLICATiON FOR PLU ENG PE MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS Z NI M ASF,
COLEMAN W JENKINS SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO _T Zb
LAVATORY 1.25 CONTRACTOR
SINS 1.25 ADDRESS b9inv-;N,
DISHWASHER 1.25 CITYj"fDkPC(4, C 1 TEL. NO.
LAUNDRY TUB 1.25 STATE LIC
LICENSE NO �j CLASS
CLOTHES WASHER 1.25DIST`f5T NIO�, GR UE ;ACNE PROCES ED BY
qro
WATER HEATER 1.50 4)t f
GAS SYSTEM OUTLETS 1'50 INDUSTRIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
U
LU
o_
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE
SV ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO C MPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGU TING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AN OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND O _
RESIDE IN, THE AB DEG D R SIDE TIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
C/�IJDATION
CK M O CASH
Iz'4' 3 3 9 1:oo JUL S 5 0 3.50-