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HomeMy Public PortalAbout5823 OAK AVE_Plumbing__ 76A667 (CE-817) - 5/73 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADORESS I..- ` ,?}HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY Ji - !'F V FOR APPLICANT TO FILL IN (PRINT OR TYPE) CROSS ST. s ` NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1,75 ou OWNE MAIL nr► ADDRESS /? i i BATH TUB 1,75 / SHOWER 1.75 �c,~ CITY f P TEL. NO. _ 4= r; LAVATORY 1.75 '7 CONTR QR7 / ! s SINK 1,75 J "" ADDRESS DISHWASHER 1.75 �� CITY } f TEL O, CLOTHES WASHER 1,75 rr STATEG./; '_ lt. CLIC LASS �� L LICENSE NO. �. ,,. SWIMMING POOL RECEPTOR 1,75 STRIC O GROUP E RVIESED BY LAWN SPRINKLER SYSTEM 1,75 r� WATER HEATER 1,75 ✓" INDUSTRIAL p WASTE APPROVAL olev GAS SYSTEM OUTLETS 1.75Lj-1INSPECTION RECO "J OUTLETS OVER .90 L` 5 PER SYSTEM r 0 w Plan check fee See Reverse I' PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEES APPROVALS DATE INSPECTOR 5 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER j. 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 LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL-PROPERTY, FINAL K C SIGNATU RE :'` ' OF PERMITTEE ✓� ''� ' j 1"�'�F✓�'G. PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH 76ASS7 (CB 017) 1/73 • If APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO ADDRESS HARVEY T BRANDT COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST c/i✓ NUMBER FIXTURE OR ITEM ® FEE 2 00 OWNER L�Di1/ O /f/�i' f/L WATER CLOSET BATH TUB 2 00 ADDRESS � i /POt��il/Cra SHOWER 200 CITYTEL NO JV LAVATORY 200 CONTRACTOR C r SINK 200 ADDRESS 0 DISHWASHER 2 00 CITY TEL NO 41 CLOTHES WASHER 2 00 STATELIC LICENSE NO OZ1p�� CLASS 1 SWIMMING POOL RECEPTOR 2 00 DISTRICT NO GROJJP ,AZO P CE BY LAWN SPRINKLER SYSTEM 200 �ppuu O iLLT /I/� WATER HEATER 200 WASTE APPROVAL a GAS SYSTEM OUTLETS 200 INSPECTION RECORD v OUTLETS OVER C� 5 PER SYSTEM 3D O C~7 W d N Z Plan Check fee See Reverse 00 PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE00 APPROVALS DATE INSPECTOR S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING +S 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 1 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 1 AM THE LEGAL OWNER OF WPM i ND TO RESIDE IN THE ABOVE DESCRIBED RE81D NTIAL PROPER FINAL FM 7S w SIGNATURE OF PERMITTER PERMIT VALIDATION CK M o CABN PLAN CHECK VALIDATION CK M o CASH l� 6 2 Ort SEP 11 5 �/1 r / 9 0 0 .9f3 a