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HomeMy Public PortalAbout5819 OAK AVE_Plumbing__ 76A667 (CE-817) — 5/73 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER r BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADORESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALI 7- FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM @ FEE CROSS ST. WATER CLOSET 1,75 ,� OWNE ?I C! *. y �> MAIL BATH TUB 1.75 ) ADDRESS SHOWER 1,75 CITY TEL. NO. rr LAVATORY 1.75 y n:" CONTQfi✓:f/ �). �? f_'f f~ :,s SINK 1.75 ' amu, ADDRESS 1 < ` r it DISHWASHER 1.75 cf S CITU 1 TEL. NO.(!(�,�.,j CLOTHES WASHER 1,75 STATE LIC LICENSE NO. ,j 7 .< CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT .O. [.��Up ZO I .:- FROG S BY LAWN SPRINKLER SYSTEM 1.75 ,,. " �" WATER HEATER 1.75INDUSTRIAL CD WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 c-�5� INSPECTION RECORD OUTLETS OVER w 5 PER SYSTEM .30 } CD d .r w F- Plan Check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE I °� APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING ' Address GAS PIPING GAS VENT City Tel. NO. HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION i 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 LICENSED AS REQU I REO BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE ESCRIBED RESIDENTIAL PROPERTY. FINAL [IllIllSIGNATURE �+ OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH .5x.`75 • .