HomeMy Public PortalAbout9520 PENTLAND ST_Plumbing__ 76i"7 (CE-817)- 5/73 t, lit/V Y
APPLICATION`FOR PLBING- PERMIT�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MARE CHECKS PAYABLE TO BUILDING, �� Q ) . A
ADDRESS L
HARVEY T BRANDY, COUNTY ENGINEER.,- LOCALITY / i� 'A' ," Il i GI
i +-
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST '
CROSS ST c ,G
NUMBER FIXTURE OR ITEM ® FEE
114
OWNERp ,.. ,t�. t t
WATER CLOSET 1 75 '
MAIL
BATH TUB 1 75 ADDRESS t •C_
i SHOWER 1 1 75 CITY � (TEL NOS V
LAVATORY 1 75 CONTRACTOR ,
SINK ' 1 75 ADDRESS
DISHWASHER 1 75 'L IJ c R
1~ CITY TEL NO
CLOTHESWASHER 1 75 STATE LIC _
LICENSE NO CLASS 1
SWIMMING POOL RECEPTOR 1 75
LAWN SPRINKLER SYSTEM j 75 DISTR IC TONG CRAP `( PR CEBSE BY
e 5 8� -/—
WATER
WATER HEATER 1 75 INDUSTRIAL
/ WASTE APPROVAL _ Y
GAS SYSTEM OUTLETS 1 75O
INSPECTION RECORD c0
OUTLETS OVER 30
5 PER SYSTEM .N , O
H
W
LL
J ' Z
Plan check fee Sea Reverse`
PLUMBING PERMIT ISSUING FEE,S' 3 00
'TOTAL FEE
APPROVALS DATE lus Pcc TON sIslrNArG Nc '
Plan check applicant UNDER SLAB WORK -
7 97
mr�
Nae - ROUGH PLUMBING
'Address GAS PIPING `
-City - Tel No GAS VENT
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 '
PLUM BI NO • ,
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOU I RED BY LOS ANGELES COUNTY, AND STATE OF - -
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE OESC (BED RE ENTIAL PROPERTY FINAL
SIGNATURE
OF pERMITTE PERMIT VALIDATION Ce D cnsH
PLAN CHECK VALIDATION CK M 0 CASH
320LIFrR 2s 514 -1 10.00e
APPLICATION FOR ,PLUMBING PERMIT - 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engmeer
County of Loa Angeles
t WM J FOX COUNTY ENGINEER BUILDING
'ADDRESS 'V
CA65ATTD GRIFFIN SUP TOF BUILDING ^
LOCALITY IP f
FOR APPLICANT TO FILL IN NEAREST
r • �.`.t. I CROSS ST
OWNERWI 't [� _�j4c4A ,S/C/lll DISTRICI-NO GROUP ZO RCAOY FOR INs;ECTION
MAIL 1 1 11 r
ADDRESS �� + r�N A��AJ e A � -�• )
CITY =1= HfXf _ TEL NO ""3 INDUSTRIAL
WASTE APPROVAL
PLUMBER D,� I INSPECTION'RECORD
ADD 5 IS
CITY TEL
LICENSE NO 3 J
NUMelp TTP.of FIXTURE OR IT.M p
WATER CLOSET (TOILET) $ '
BATHTUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER '
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO 080 u APPROVALS
DATE INSP CTOR S SIGNATURE
GAS SYSTEM-OUTLETS a 100I
UNDER SLAB WORK S
If WATER HEATER 9D 1 00
ROUGH PLUMBING
PERMIT 4 1 00
/� GAS PIPING
TOTAL FEE /(/ GAS VENT
IH
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GASTEST
LICENSED AS REQUIRED BY LOS AN LES COUNTY AND STATE OF UTILITY CO NOTIFIED
CALIFORNIA OR THAT 1 4y� HE AL OWNER OF THE ABOVE
DESCRIBED RFSH)6NTIAL PR PE
t +
SIGNATURE
OF PERMITTE �' FINAL S
WILLIAM J 2!!X
OUNTY ENGINE R` VALIDATION R A WOOD CHIEF PLBG INSPECTOR
{��07 3 0 5� AUG30 3 /2.8 0 n