HomeMy Public PortalAbout8746 GARIBALDI AVE_Plumbing__ 76A667 (CE-617)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
ADDRESS y
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM 0 FEE
WATER CLOSET 1.75 OWNER
MAIL
BATH TUB 1,75 ADDRESS
SHOWER 1,75 CITYTEL. NO. (a
LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY67 VV TEL N0.
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.75
LAWN SPRINKLER SYSTEM 1.76
-47 DISTRICT NO. GROUP ZONE RROCESSED BY
WATER HEATER1.75 INDUSTgIgL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER 30
6 PER SYSTEM
Plan check fee S.. Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSP[cro R'a SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING d 8-7
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE IS CORRECT AND ACRE[ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS R[GULATIMG
PLUMBING. GAS TEST
I HERESY CERTIFY THAT I AM PROPERLY REGIBTKRED AND/OR UTILITY CO. NOTIFIED
LICENSED Al REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LESAL OWNER OF, AND IMT[ND TO
RESIDE IM THE ABOVE DEBCRISED RES IDMTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALID TI4 cK. M.o. cA.BH
PLAN CHECK VALIDATION CK. M.0. CASH
j},;Q9 5 1 9�3 XT 3 0 5 D CV
V