HomeMy Public PortalAbout5921 AVON AVE_Plumbing_5/28/1976_water softner 76A667 (CE-817)- 5/73 ..
APPLICATION FOR PLUMBING PERMIT -
COUNTY
EIRMIT •COUNTY OF LOS ANGELES .
DEPARTMENT OF COUNTY ENGINEER 44
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS 5921'Avon Avenue
HARVEY T.,BRANDT, COUNTY ENGINEER
- LOCALITY San Gabriel
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
@ FEE ..
CROSS,ST:
NUMBER FIXTURE OR ITEM
WATER CLOSET 1.75 OWNER Clifford HoCollin's
MAIL
BATH TUB 1,75 ADDRESS 5921 Avon Ave o y
SHOWER 1.75 CITY San Gabriel, YE :No.
LAVATORY 1,75. CONTRACTOR Servisoft Of San,'Gabriel
SLNK. 1.75 ADDRESS $428 Ee .Clanton Ste ,
DISHWASHER 1.75 CITY TEL. N
CLOTHES WASHER 1,75 STATE LIC
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. 2038CLASS Ci
DISTRICT NO. GROUP Z CESSED BY
LAWN SPRINKLER SYSTEM 1.75 "1. b
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL }:
GAS SYSTEM OUTLETS 1-.75
OUTLETS OVER INSPECTION RECORD CD CC..)
5 PER SYSTEM. .30
O
1 Ikter W
Rental z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
• TOTAL FEE _
APPROVALS DATE INSPECTOR'S SIGNATURE
.Plan check applicant , UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING'
City Tel. NO. GAS VENT
! `.�I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION HOT WATER HEATER L>
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES U
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF y
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO - N. '
RESIDE IN THE ABOVE DESCRIBE ESI DENT I AL PROPERTY. FINAL
SIGNATU RE
OF PERMITTEE -
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDA ION CKO. cASH _