HomeMy Public PortalAbout5133 ARDEN DR_Plumbing__ 7GA667A(CE817A) - 8/75
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ; -7 a
MAKE CHECKS PAYABLE TO: BUILDING ADDRESS l� 7 bYr�t�'L1 r�y
HARVEY T. BRANDT, COUNTY ENGINEER ti
LOCALITYj2/0' C
L
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE r / G�/
G7 nC3 OWNER 1'Pt-4 n L lJu�t
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER C CITY TEL. NO.
LAVATORY (� CONTRACTOR ) ,w ` p1i
L7 a-Y,/P16 js C?4�d4� /�f•'t�Jl�li.� lie
f SINK Cc) ADDRESS ?9
' DISHWASHER t)()
CITY C��tl/,L!3� TEL. NO.
CLOTHES WASHER '!:3 STATE LIC
LICENSE NO. + CLASS
SWIMMING POOL RECEPTOR
DISTRICT NO. GROUP ZONEY
LAWN SPRINKLER SYSTEM �._, `� T- ie, 9FROtOSED Bg� Y
eq
WATER HEATERS C)C% INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS INSPECTION RECORD 91.
OUTLETS OVER
5 PER SYSTEM u
F�
�A
68e
0.
19f
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK -7—/3-2 x"': ,", ,
Name ROUGH PLUMBING
Address GAS PIPING
2
City Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY.ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES ,7
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST 13 9i
I 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,I AM THE LEGAL OWNER OF, AND INTEND TO --
RESIDE IN THE ABOVE DESCRIBED RESI DENTIA ROPER TY. FINAL i
SIGNATURE /1 J9
OF PERMITTEE / / 1 Y
E MIT VALIDATION cK.' M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
7 .9,.S;r 6 5 ;+ 3 75 0 AE2