HomeMy Public PortalAbout5940 1/2 CAMELLIA AVE_Plumbing__ 76A667 (CE-12117)-B-71
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM 0 FEE
WATER CLOSET 1.76 OWNER
MAIL
BATH TUB 1.76 ADDRESS
SHOWER 1 ,76 CITY TEL. NO.
LAVATORY 1.76 CONTRACT
SINK 1.76 ADDRESS
DISHWASHER 1.76 CITY TEL NO
CLOTHES WASHER 1.76 STATE LIC
SWIMMING POOL RECEPTOR 1.76 LICENSE NO. CLASS
DIS7T NO G UP ANE ESSE BY
LAWN SPRINKLER SYSTEM 1,76
C/
WATER HEATER 1.75 WASTE APPRINDUSTRIAL
OVAL
GAS SYSTEM OUTLETS 1.76 O
INSPECTION RECORD
V
OUTLETS OVER
6 PER SYSTEM .90 �•
r0
V
W
106
CA
Z
Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE 8 3 00
TOTAL FEE
APPROVALS DATE IMO P[CTO R'! EISNATUR[
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
AddresB GAS PIPING
Clty Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
H
AND STAT[ THAT THE ASOVE IE CORRECT AND AGR[[ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINAHCED AND STATE LAWS RESULATING
PLUMEIIIG. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR UTILITY CO. NOTIFIED
LICENSED AE REQUIRED BY LOE ANGEL[■ COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE L[SAL OWNER OF, AND INTEND TO
RESIDE IN THE AEOV[ D[ RIE R[SID[MTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALID I i 'l• O. CAeH
PLAN CHECK VALIDATION CK. M.o. CASH
4.'�5^'
1 0 3 6i3 FU 14 5 0