HomeMy Public PortalAbout4912 DOREEN AVE_Plumbing__ 76A657 ICE-6171 - 5/73 �/}}''jj_'l��_ ( _
APPLICATION FOR PLLIMBkG PERMIT`
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHUCKS PAYABLE 70: .,� I BUILDING
ADDRESS 4912 N. rporeen'Avenue
HARVEY T. BRANDT, COUNTY ENGINEER
i 'LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEAREST /J
NUMBER FIXTURE OR ITEM @ FEE - CROSS ST. .�
,OWNER -Louis R. .Sloan'
WATER CLOSET 1.75 '
BATH TUB 1.75
aooaEss 4912 N. Doreen Avenue
SHOWER 1.75 CITY Tem6le cit TEL. No'.", 443-5289
LAVATORY 1,75 CONTRACTOR Trane H C C
SINK 1,75 ADDRESS 2034 N. Peck Road
DISHWASHER 1.75
r cITY 'So. El M_onte ' TEL No...579-7982
CLOTHES WASHER 1.75 STATE LIC
_ /..
LICENSE NO: 265094 CLASSC-20.'
SWIMMING POOL RECEPTOR 1,75
DISTRICT NO. GROUP -ZONE /FRO ESSEO By
_
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL _ _
1
GAS SYSTEM OUTLETS 75 175 INSPECTION RECORD CD
OUTLETS OVER
5 PER SYSTEM .30 5
ED
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'Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE 5 3 DD
TOTAL FEE 4. 75 -
APPROVALS DATE INS PEC TOP'S 91f.NAT110.E
Plan check applicant UNDER SLAB WORK
Name r ROUGH PLUMBING
Address _ GAS PIPING -7771�w,fy,f
City Tel. No. GAS VENT
HOT WATER HEATER
I HEREBY THAT
TH LEDGE THAT HAVE READ THIS HOT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE E COMPLY PLUMBING FIXTURES M 1_ '
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING "FINAL
Y/ 9//
PL DM BING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED PND/OR r
LICENSED AS RTHATID BY LOS ANGELES COUNTY ANLSTATE CALIFORNIA OR THAT AM THE LEGAL OWNER TY ANpRESIDE IN THE ABOVE DESCRIBED RESIDENT( L PROPER1y 75SIGNATURErOF PERMITTEE ION CH. M.O. CASH
PLAN CHECK VALIDATION CK. M.D. CASH 4.7 5
7 3 3�NUY 13 5 D
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