HomeMy Public PortalAbout4921 MCCLINTOCK AVE_Plumbing__ 76A887-CE0817 4-67
APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS ANGELES
DEP
OF COUNTY ENGINEER
BU URNS AND SAFETY DIVISION BUILDING '
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 9z/ All CC L i;/ Mode
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY 7
FOR APPLICANT TO FILL IN NEAREST t
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNED p S G/l7 S(:�
WATER CLOSET S"5 AoMAIL
BATH TUB y2S ;s0 ADDRESS
lSHOWER /•Sd CITY TEL. NO.
LAVATORY o CONTRACTOR F�Q
SINS a ADDRESS 14C) �.ci
DISHWASHER 1.25 O CITY TEL. NO.3%%STATE LIC
LAUNDRY TUB 1.25 J! LICENSE NO. (� CLASS ��'-3�
CLOTHES WASHER DISTRICT NO. GROUP ZONE PROC SEED BY
__f- WATER HEATER 1.50 -3^ (y � 1
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL O"
WASTE APPROVAL v
OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD
O
•W
Cn
O
• Z
APPROVALS DATE INSPEC'TOR'S SIGNATURE
PERMIT $ 2 OQ UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE I I'
GAS PIPING
I HEREBY•ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
i HEREBY CERTIFY'THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN.THE ABOVE DESCRIBED RESIDENTIAL P ERT'. UTILITY CO.NOTIFIED
SIGNATURE /_
OF PERMITTEE LV
FINAL
CLMATION
JACK R. ALLEN
M.0. CASH SUPERVISING MECHANICAL ENG'R.
"FEB15 5 D 1- 7.00N 1 . .