HomeMy Public PortalAbout6028 AVON AVE_Plumbing_3/17/1976_water heater 76A667 (CE-817) 175
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO ADDRESS
HARVEY T BRANDT, COUNTY ENGINEER ADDRESS
LOCALD
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
4 if
NUMBER FIXTURE OR ITEM CROSS ST
p FEE
2 00 OWNER �1te
WATER CLOSET MAIL T!
BATH TUB 2 00 ADDRESS 44
SHOWER 200 CITY TE�
LAVATORY 200 CONTRACTO
SINK 200 ADDRESS J�
DISHWASHER 200 CI
CLOTHES WASHER 200 STATEClSWIMMING POOL RECEPTOR 2 00 LICENSE NO d CI
Y LASS 0'-3 19
DISTRICT NO GROUP ZONE R SSED Y
LAWN SPRINKLER STEM 2 00 L—� U _( _72 1ju
WAWiE 200 INDUSTRIAL
WASTE APPROVAL
GAS S EM OUTLETS 200 INSPECTION RECORD a
OUTLETS OVER O
5 PER SYSTEM 30 V
- O
U
� , W
Cn
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name c ROUGH PLUMBING
Address GAS PIPING
City Tel No GAS VENT
HOT WATER HEATER
I 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
PLUMBING GAS TEST
I I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALI FORNIA OR THAT I AM THE LEGAL OWNER OF AND INTENb
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATIONcK M 0 CASH
PLAN CHECK VALIDATION CK M 0 CASH
7 5MAR i7 5 0 7.50 Ada