HomeMy Public PortalAbout9416 BROADWAY_Plumbing__ 7&A 647-(C E-817)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAY/IHLE TO: BUILDING
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER _LOCALITY,
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1.75
MAIL
BATH TUB 1.75 ADDRESS
SHOWER 1,75 CITY TEL. NO.
LAVATORY 1,75
CONTRACTOR '
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITVS4� EL. N0'
CLOTHES WASHER 1.75 STATE - LIC
E 0./ ,� CLASS C 3
SWIMMING POOL RECEPTOR 1.75 75
LICENSN
DISTRICT NO. GR UP ZONE ESSED BV
LAWN SPRINKLER SYSTEM 1.75 1< / ,-/
WATER HEATER 1.75 INDUSWAS APPROVAL �/
a
GAS SYSTEM OUTLETS 1.75 INSPECTION RECOR V
OUTLETS OVER BO
5 PER SYSTEM
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ B 00
TOTAL FEE
APPROVALS DATE IIIS PEC TO R'S 1I1.N4Tt1RE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address �A.� 5 GAS PIPING
City- el. NO.p�0,aab GAS VENT
NOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FI4309
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING -
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY db—NOTIFI40 J
LICENSE EOUIRED BY LOS ANGELES COUNTY AND STATE OF _
CALI FO RN OR AT 1 AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN TH RO RESIDENTIAL PflOPER TY. TINAL
SIGNATU E
OF PE MITTE
PER VALIDATION .O. CASH
PLAN CHECK ALI DATION CK. M.0. CASH IWJ/
1 nr 2 7 6 27' Auer 6 5 D 6504