HomeMy Public PortalAbout6274 LOMA AVE_Plumbing__ 76 A 667—CE: 817 8/68-
APPLICATION
/68-APPLICATION FOR PLUMBING P RMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ,
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE "
..:. ........... OWNER
� r
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRESS ,z '7L,
SHOWER 1.50 CITY C. TEL. NO. 7�G
LAVATORY 1.50 CONTRACTORLAJ Y\V.
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GROUP. E R ESSED BY a
LAWN SPRINKLER SYSTEM 2.00 J 0( / �%Tl.. U
WATER HEATER 1.50 INDUSTRIAL p
WASTE APPROVAL
l GAS SYSTEM OUTLETS 1.50 yy►►�� W
]7� INSPECTION RECORD
OUTLETS OVERGO
.3G
5 PER SYSTEM Z
I -
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 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
1 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.
1 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 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE 9i�') JACK R. ALLEN, SUPERVI51 CHANICAL ENG'R.
OF PERMITTEE �Q- ��"
PERMIT VALIDATIO cK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH