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HomeMy Public PortalAbout4853 CLOVERLY AVE_Plumbing__ 76A667 rjV-811 7) - 1/75 APPLICATION FOR PLUI,A'BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER n BUILDING AND SAFETY DIVISION BUILDING f( all-Z/ M /i MAKE CHECKS PAYABLE TO ADDRESS U iJ V, 00 c.i HARVEY T BRANDT, COUNTY ENGINEER LOCALITYa4211� a, FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 200 MAIL jJ BATH TUB 200 ADDRESS jam--- ��jj SHOWER 200 CITY TEL NO y �_3 f� LAVATORY 200 CONTRACTOR _ < i SINK 2 pp D ADDRE i� I DISHWASHER 200 6 CJ CITY TEL NO __ V CLOTHES WASHER 200 3 G STATE LICENSE NO 3�1� LIC C LGA! 3,� SWIMMING POOL RECEPTOR 2 00 DISTRICT NOGROUP /a ZONE CESSED BY LAWN SPRINKLER SYSTEM 2 pp �^� 0 9 f 1J + WATER HEATER 200 ��f INDUSTRIAL \J�� , WASTE APPROVAL a GAS SYSTEM y OUTLETS 2 00 d INSPECTION RECORD U OUTLETS OVER pC 5 PER SYSTEM 30 O f- lE cL 3 G O aUW cn z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE ' APPROVALS DATE INSPECTOR 9 SIGNATURE Plan check appl(Cant UNDER SLAB WORK122--76 Name ROUGH PLUMBING �) Address GAS PIPING fzx- City Tel NO GAS VENT r HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES p � WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING GAS TEST ` ,�f�(, a -------- I HEREBY CERTIFY T T I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRE B LOS ANGELES COUNTY ND STATE OF V CALIFORNIA OR THAT THE LEGAL OWNER OF ND INTEND TO RESIDE IN THE ABOVE S (BED RESIDENTIAL P FINAL SI GNA TU RE -' OF PERMITTE PERMIT VALIDATION GcKM o CASH PLAN CHECK VALIDATION CK M 0 CASH A 9 0 5 U 2 2.5 0 ©`8 76,4667 CE.#'B'7 2 62 APPLICATION FOR PLU BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT-OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FBBUILDINGJOHN A LAMBIE COUNTY ENGINEER DRESSWILLIAM A JENSEN SUPJ OF BUILDING CALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM EACH FEE OWNER y�Z� WATER CLOSET $125 f Iv MAIL BATH TUB 125 ADDRESS SHOWER 125 J` CITY TEL NO LAVATORY 125 -2- ov CONTRACTO SINK 125 / J ADDRESS DISHWASHER 125 CITY TEL NOCONTRA REGISTRATOR S TION ION NO / STATE ❑ LAUNDRY fUB 125 COUNTY ❑ CLOTHES WASHER 125 DISTRICT N GTP ZONE P ffr5"S BY pl WATER HEATER 150 V�' 6) �v ` GAS SYSTEM OUTLETS 150 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD 09 o W d to z APPROVALS DATE INSPECTOR S SIGNATLk5E PERMIT $ 2 OO UNDER SLAB WORK �A Q ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT ` AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 1 ' V Y LICENSED AS REQUIRED_BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO _ LSIDE IN THE ABOVE DESCRIBED RE IDENTIAL PROPERTY UTILITY CO NOTIFIEDGNATUREMOM F PERMITTE MM FINAL H O ALIDATION ROBERT,i( WOOD CK M O CASH SUPERVISING MECHANICAL ENG R , 1 1 L 05249%-D OCT 8 5 D r