HomeMy Public PortalAbout5942 CAMELLIA AVE_Plumbing__ 76A667 (CE-817)-8-71
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
LOCA LITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST L
NUMBER FIXTURE OR ITEM O FEE OWNER /
WATER CLOSET 1.76
MAIL
BATH TUB 1.75 ADDRE r
SHOWER 1 .76 CITY TEL. N(
LAVATORY 1.76 CONTRAC R ,-
SINK 1.76 ADDRESS
DISHWASHER 1.76 CITY TEL N C
CLOTHES WASHER 1.76 STATE LIC r�
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.76
rl-
DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEMA 1.76
WATER HEATER 1.76 y IN
WDUSTAPPFl
OVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER
6 PER SYSTEM .30 Z
0
W
O.
Vf
Z
Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
I H[R[SY ACKNOWLEDGE THAT I HAVE E
[ RAD THIS APPLICATION
AND STAT[ THAT THE ABOVE Ie CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMS IMO. GAS TEST
1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR UTILITY CO. NOTIFIED
LA
NSED A• REQUIRED BY LOS ANG[L[e COUNTY AND STAT[ OF
1,04RN IA OR THAT I AM TH EGA M[R OF, AND INTEND TO
DE IM THE ASOV[ o[ec D R ID[NTIA PR RTY FINALNATUREF PERMITTEE
PERlv11T VA
PLAN
M.O. ASH
PLAN CHECK VALIDATION CK. M.O. CASH
L�0 0 4 5 n� - 5 D 4r75' V