HomeMy Public PortalAbout5339 MCCULLOCH AVE_Plumbing__ . 76A667�(CE-817)- 5/73
APPLICATION F R PLUMB G• PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS J N f5 n^� .( �LLC�f--�I
HARVEY T. BRANDY, COUNTY ENGINEER 1. LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER -FIXTURE OR ITEM_ @ FEE
WATER CLOSET 1,75 �.a� OWNER � s&pkvf'�(A i\%,k
V� MAIL `p
1 BATH TUB 1,75 '1.5 ADDRESS S-i�a a— MCCULL-or-Fl AVE:
SHOWER 1,75 5 CITY - ( TEL. NO.
' LAVATORY 1,75 CONTRACTOR
SINK 1.75 ADDRESS '
DISHWASHER 1.75 CITY TEL. NO.
CLOTHES WASHER 1.75 STA TELIC
LICENSE N CLASS
SWIMMING POOL RECERZOR 1.75
DI ICT N�. GROUP �DN(E CESSED Y
LAWN SPRINKLER SYSTEM 1.75 Q "r
WATER HEATER 1.75 INDUSTRIAL
ATE A
W
GAS SYSTEM OUTLETS 1.75 IAL INSPECTION RECORD v
OUTLETS OVER ,30
5 PER SYSTEM
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W
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00 '
TOTAL FEE .
APPR $ ti
W DATE INSPECTOR'S SIGNATURE
Plan Check applicant UNDER • WORK 1
Name �� ` .��� ROUGH PLUMBING I wof a 40075 $'j/ ^,►/+t' _
AddresS6` % Q GAS PIPING � "P
Y GAS VENT
Cit ��t, Cil Tel. Nd. �� 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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ,
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED REN L PROPERTY. FINAL
SIGNATU RE AV
OF PERMITTEE
PERMIT VALIDATION M.0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
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