HomeMy Public PortalAbout9072 ACASO DR_Plumbing_7/25/1975_fixtures and under slab 7GAG67 (CE-S17) - 1/75
• APPLICi4Tl0 FOR P MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDING ADDRESS CIO pG S o
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY ,+
FOR APPLICANT TO FILL IN (PRINT OR TYPE) CNEAREST
ROSS ST SC R6 N 6 '
NUMBER FIXTURE OR ITEM @ FEE _/
l WATER CLOSET 200 OWNER LC�`<< 1� STG/�13 A e-If
BATH TUB - 200 MAILADDRESS 9 0 7y CA$ 0
SHOWER 200 CITY :rLj-,_gL6 G� TEL NO
LAVATORY 200 �� CONTRACTOR
SINK 200 ADDRESS
DISHWASHER 2 00 CITY TEL NO
CLOTHES WASHER 200 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 200
DISTRICT NO GROUP / ONE PRO ESS D BY
LAWN SPRINKLER SYSTEM 2 00 '5 / �/ _ _ _
WATER HEATER 200 INDUSTRIAL \J�
WASTE APPROVAL
GAS SYSTEM OUTLETS 200 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM 30
O
v
W
d
N
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE S 3 00 =
TOTAL FEE ('
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check appQa
nt UNDER SLAB WORK
Name ROUGH PLUMBING C� c
Address GAS PIPING q i/ — (7 rr
City el NO GAS VENT
HOT WATER HEATER
1 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 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THA T.1
AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL 42
SIGNATURE
OF PERMITTEEZ-11. n^^1
PERMIT VALIDATION (CK o CASH
PLAN CHECK VALIDATION CK M O CASH
1 7 ZAP JUL 2 5 1 0.0 0 ♦t�