HomeMy Public PortalAbout5731 NOEL DR_Plumbing__ 78A587 (CE i817) 4/72
` APPLICA FjR�rPtUM!314 PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DIVISION BUILDING `y
MAKE CHECKS PAYABLE TO ADDRESS v
HARVEY T BRANDT COUNTY ENGINEER 4 LOCALITY
FOR APPLICANT TO FI`LL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM FEE
WATER CLOSET 1 75 OWNER
MAIL
BATH TUB 1 75 ADDRESS
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SHOWER 1 75 CITY TEL N
LAVATORY 1 75 CONTRACT46R
SINK 1 75 ADDRESS
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DISHWASHER 1 75 CITY TEL NO
CLOTHES WASHER 1 75 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 75
DISTRICT NO GROUP NE OC SE Y
LAWN SPRINKLER SYSTEM 1 75 !�
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WATER HEATER 1 75 WASTETRIAROVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RE RD v
OUTLETS OVER 30
5 PER SYSTEM �
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR 4 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 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
LICENSED AS 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 RESIDE IAL PROPERTY FINAL Q
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SIGNATLI RE
OF PERMITTEE
PERMIT VALIDATION cK M 0 CASH
PLAN CHECK VALIDATION CK M 0 CASH
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