HomeMy Public PortalAbout5415 HILTON AVE_Plumbing__ 76A667 (CE-817)-9/72 , A 1�/ 2 1.f/
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 1
WAKE CHECKS PAYABLE TO: ADDRESS .57 5
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY
FLAWN
PLICANT TO FILL IN (PRINT OR TYPEI NEAREST
CROSS ST.
FIXTURE OR ITEM @ FEE
CLOSET 1,75 - OWNER ! 4'ppOs A GL-S.upj
MAIL
MA
ADDRESS ( Dp ?4 L{.�
TUB 1.75 ' 7s
ER 1,75 r CITY f,�LF.�-y�,N�� TEI. NO.
TORY 1.75 jQ CONTRACTOR 1.75 ADDRESSASHER 1.75CITY r- ; TEL. NO. Yti3.ES WASHER 1.75 � STATE qq ) LICLICENSE NO. o' D � 7y/ CLASSING POOL RECEPTOR 1.75
DISTRICT NO. GROUP ZONE FR CESSED BY
SPRINKLER SYSTEM 1.75 �HEATER 1.75 ,s INDUSTRIAL .Y
WASTE APPROVAL a
' GAS SYSTEM OUTLETS 1.75 y INSPECTION RECORD U
OUTLETS OVER �) ¢
5 PER SYSTEM .30 // J-9�iLGc� Y Q - /J� O
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 DO
TOTAL FEE .}, �-�)
APPROVALS DATE Ira Pec TO R's sIRe ATU RE
Plan cheek applicant MARKLAB WORK /-B-7Z,.9/,
Name LUMBING
Address ING r
City Tel. No. T
ER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY G FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING -
PLUMBING. T 3I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR CO. NDTIFIEDLICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OFA AND INTEND TORESIDE IN THE ABOVE DE CRIBED RESIDENTIAL OPERTY. / `•�
SIGNATURE
OF PERMITTEE `L�
PERMIT VALIDATION rc.t .0. CASH
PLAN CHECK VALIDATION CK. M.D. CASH
Liio9 6 7 3N NOV g 0 2.25