HomeMy Public PortalAbout5301 ZADELL AVE_Plumbing_1/7/1975_ 76A667 (CE-817)- 5/73
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION _
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST I
(A.>d 1�I�
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
WATER CLOSET 1,75 OWNER �G r,
MAIL U w�
BATH TUB 1,75 ADDRESS Tx'
SHOWER 1,75 CITY ( ct WEL. N0.
LAVATORY 1.75 CONTRACTOR
' SINK 1,75 ADDRESS
DISHWASHER 1.75 CITY I. TEL. NO.
CLOTHES WASHER 1,75 STATELIC
LICENSE NOV CLASS
SWIMMING POOL RECEPTOR 1,75
DISTRICT NO. 'GROUP ZONE PROCESSED BY '
LAWN SPRINKLER SYSTEM 1,75 y ✓ f r'
WATER HEATER 1,75 INDUSTRIAL 75— /�rJ�C
ASTE APPROVAL
GAS SYSTEM OUTLETS 1,75 ,; INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 O
H
V
, W
a
H
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 46
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK ,
Name ROUGH PLUMBING F
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
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 I AM THE LEGAL OWNER OF, APIA INTEND TO
RESIDE IN THE ABOV IBED RESIDE IAL.PROP FINAL
SIGNATURE
OF PERMITTE C
PERMIT VALIDATION OCKM.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
3 4 SrJ 7 5 D 6,5 0 Aua