HomeMy Public PortalAbout4935 HALLOWELL AVE_Plumbing__ 76A667�(CE-817) -9/79
APPLICATIONFO.R,PL MB1N_G PERM.IT
COUNTY OF LOS ANGELES.
"DEPARTMENT'OF COUNTY ENGINEER
BUILDING.AND SAFETY DIVISION
MAKE%CHECKS PAYABLE-TO: 7RE'HARVEY-T. BRANDT, COUNTY ENGINEER-
FOR APPLICANT,TO FILLIN (PRINT OR TYPE)
NUMBER FIXTURE OR ITEM @ FEE, „
.0o, OWNER
a WATER CLOSET 6 00'
MAIL.
BATH TUB. `J:00 3 00. ADDRESS,
I SHOWER J.00 3 OQ CITY' . TE :NO. 6'16 Sp
a
�. _LAVAT,ORV" :00 6 DO.-t. CONTRACTOR, ,
fj SINK 100', 3- 00 ADDRESSb.
42651 -Baldwin Ave.,-
DISH ASHER
ve.DISHWASHER00 3 00 , CITY TEL. NO, 44 _
I CLOTHES'iWASHER " ' 3:00 3 00'- STATE ^ LIC
LICENSE NO,231 •�`+� CLASS C36,20
SWIMMING POOL RECEPTOR. 3100
DISTRICT NO.GROUP ZONE ESS€D BY
LAWN SPRINKLER SYSTEM 3,00
WATER,HEATER x.00- 3 QQ, •INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM ' OUTLETS 3.00 3'OQ. .INSPECTION RECORDCD
'-
a
OUTLETS OVER /� ��r6- 70, p1�
5'PER SYSTEM 30 !/ (�li
`Plan Check fee• See Reverse °
PLUMBING,PERMIT ISSUING FEE' $1 50
TOTAL FEE �.� s"� '
APPROVALS' DATE'. INSPECTOR'S SIGNATURE
Plan Check appl,ICant UNDER SLAB WORK
Name' ROUGH PLUMBING
Address - GAS PIPING. -�
Clty�. TeI.. N0. ° GAS VENT
HOT WATER-HEATER
I HEREBY ACKNOWLEDGE THAT L HAVE READ ,THIS APPLICATION
AND STATE TH'AT-THE ABOVE+•IS CORRECT AND AGREE TO'COMPLY PLUMBING FIXTURES
WI THS ALL' COUNTY ORDINANCES- AND STATE LAWS'REGULATING
PLUMBING. GAS TEST ;
I HEREBY'CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.`NOTIFIED -
LICENSED' AS REQUIRED BY LOS ANGELES COUNTY AND STATE,OF
CALIFORNIA, OR THAT I AM THE LEGAL• OWNER OF, AND INTEND TO
RESIDE IN"THE ABOVE CRI D RESIDENTIAL PROPERTY, FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION _ cK: M:o. cases•
PLAN CHECK VALIDATION CK. M.0. CASH
JAS 14 .5.