HomeMy Public PortalAbout8616 ROCCUS LN_Plumbing__ 7A 697'CFVS,77 5/69
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST ' !' ��
CROSS ST:. Com'
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 v.
Mau
BATH TUB 1.25 ADDRESS
SHOWER 1.25 1 CITY TEL. NO.
LAVATORY 1.25 CONTRACTOR �.�
21-
SINE 1.25 ADDRESS
DISHWASHER 1.25 CITYE NO..!/
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY
WATER HEATER 1.50 S 'I a..-r
1
GAS SYSTEM OUTLETS .50 INDUSTRIAL a O
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD
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APPROVALS DATE y INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
ROUGH PLUMBING'/; �E i
TOTAL FEE c 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 COUNTY ORDINANCES AND STATE LAWS REGULATING
UMBINGHOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST q R'
CALIFORNIA OR THATf THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE__ CRIBED RESIDENTIAL P PERTY. UTILITY CO.NOTIFIED G �
i
SIGNATURE
OF PERMITTEE
FINAL •�bs /.�� �H�
LIDATION ROBERT A.WOOD
CK.
m.0. CASH SUPERVISING MECHANICAL ENG'R
LAGO 3 0 2 1% AUG 2 4 5 A 1625- 1
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