HomeMy Public PortalAbout6205 KAUFFMAN AVE_Plumbing__ 76A887 (CE-817) - 1/75 `--s�`r .
APPLICATION FO PLUM G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: ADILDING
DRESS
HARVEY-T. BRANDT, COUNTY ENGINEER
LOCALITY
FOR APPCICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE.
WATER CLOSET •
2.00' OWNER
MAILM /
BATH TUB, 2,00 ADDRESS
SHOWER 2.00 CITY' Ltayl�fLE Z TEL. NO.)8
LAVATORY• 2.00 CONTRACTOR 17_17<11k6__1
'
SINK 2.00 ADDRESS ty
d
DISHWASHER 2.00CITY 7f O[D TEL. NO;
CLOTHES WASHER 2.00 STATE• LIC3,
90 7 k
SWIMMING POOL RECEPTOR, 2.00 LICENSE NO. CLASS
DISTRICT NO.GROUP, ONE RO SSED BY
LAWN SPRINKLER SYSTEM 2.00 1
/
WATER HEATER v 200 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM , OUTLETS 2.00 INSPECTION RECORD." " v
OUTLETS OVER . �! �,'p r/p _ ,,.e,'
5 PER SYSTEM' •30 '/l SA-� �/ I `-- O
C-3
a
N
• Z
Plan check fee See Reverse s
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
171- APPROVALS, DATE' INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
',C'Ity Tel. NO.- GAS VENT
`Y HOT WATER HEATER
.I ,HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES -`�'. �•'"`•'
,AND STATE
ORDINANCES AND STATE LAWS REGULATING
PLLUM SING:`. - GASTEST
I HEREBY CERTIFY THAT IAM"PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED.-Ai REQUIRED BY,L0S ANGELES COUNTY AND -ST EP,OOF '
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF ND IN TO
RESIDE IN THE ABOVE DESCRIBED RESIDEN AL P ER TY'. FINAL
00,
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
7 3 .9 rm,�P, 16 5 D 7.5 0 ,&=,d