HomeMy Public PortalAbout5563 HALLOWELL AVE_Plumbing__ 76A667,(CE-817) - 1/75 ( -
APPLICATION F R PLUMBING PERMIT {�
COUNTY OF LOS ANGELES �J
DEPARTMENT OF COUNTY ENGINEER �✓
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST. �
WATER CLOSET 2.00 OWNER 0(�
BATH TUB 2.00 MAIL�� ADDRESS
SHOWER 2.00 pD CITY TEL. NO. d-97-%e
3 LAVATORY 2.00 On CONTRACTOR
SINK 2.00 0() ADDRESS
DISHWASHER 2.00 CITY TEL. NO.
CLOTHES WASHER 2.00 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 2.00
DISTRICT NO.7"7—
WATER
ZONE0�,�ZC�ESS D BY
LAWN SPRINKLER SYSTEM 2,00 � 0 Q ) —72-u;;'
c
HEATER 2.00 d INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM '2—OUTLETS 2.00 3 DU INSPECTION RECORD CD
OUTLETS OVERr� C'
/� ry C,.)
5 PER SYSTEM •30 v1 ty [C,•a" (/ a / Cd
O
U
W
N
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City
Tel. NO. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST o S,
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR T AT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE AS DESCRIBED RESIDENTIAL "OPERTY, c FINAL Q°'(�.��•
SIGNATU RE 1 ��'-' ''�+"
OF PERMITTEE l�
PERMIT VALIDATION M,O: CASH
PLAN CHECK VALIDATION CK. M.0. CASH
111 crR 10 5 D 49.50m
C3 ✓G