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APPLICATION R P'LU BING PERMIT {�
COUNTY OF LOS ANGELES LI
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS 5914 NorthMuscatel
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY S Gaberi 1
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1,75 OWNER S andard American Builders
AIL
BATH TUB 1.75 tf
ADDRESS 5714 North Muscatel
SHOWER 1,75 CITY San Gaverial TEL. NO.
LAVATORY 1.75 CONTRACTOR D & A Plumbing
SINK 1.75 ADDRESS East Manchester Ave.
DISHWASHER 1.75 CITY s Angeles TEL. NO. 1�.7�25
CLOTHES WASHER 1.75 STATE ' LIC
LICENSE NO. 66544 CLASS C-36
SWIMMING POOL- RECEPTOR 1.75
DISTRICT NO. GROUP ZONE CESSED BY
LAWN SPRINKLER SYSTEM 1.75 5'. C' i _� r
WATER HEATER 1.75
WASTETAPPR O V A LCD
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GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER 30 C
5 PER SYSTEM
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE `
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING -�7 ,_ 'f iu�1.CT'3✓
Address GAS PIPING
City Tel. NO. GAS VEND
HOT WATER HEATER
1 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
PLUMBING. _GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSEDAS REEIUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DE BED RESIDENTIAL PyPERTY. FINAL
,ra y
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATI N CK. .0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH e�
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7 0 7 C'Z NOV 1.2 5 0 1 1.7 5 Aga