HomeMy Public PortalAbout5608 PERSIMMON AVE_Plumbing__ 76A667(CE-817)- 5/73
f APPLICATION' FOR PLUMBIN ' . ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESSlDO
HARVEY T. BRANDT, COUNTY ENGINEER.
LOCALITY CtAf
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST i
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NUMBER FIXTURE OR ITEM @ FEE ' CROSS ST.
WATER CLOSET 1,75 OWNER, �:.
MAIL
BATH TUB 1.75 " ADDRESS'
SHOWER 1,75 CITY TEL!. NO.
I 000l/
LAVATORY 1.75 CONTRACTOR ,v
SINK 1.75 ADDRESS
DISHWASHER 1.75
CITY U TEL. N : a.
CLOTHES WASHER 1,75 STATE C 7� �f� LI
LICENSE.NO , O CSL SS -�
SWIMMING POOL RECEPTOR 1.75 ` � -
` D CT NO �UP NE 'PROCESSED BY
LAWN SPRINKLER SYSTEM 1,75 1
WATER HEATER 1,75 INDUSTRIAL
WASTE APPROVAL a
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER e77 y� !
5 PER SYSTEM .30 r6.�nQ l ,� 'U'Ll-612. r-04+ OO..&'I Py�Ga06 �
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Plan check fee See Reverse rb TL-(d E-L`(�.Y71e'N1-*3a
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PLUMBING PERMIT ISSUING FEE $ ,�C3 00
TOTAL FEE 6 1
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan Check applicant UNDER SLAB WORK
Nagle ROUGH PLUMBING +Z,Q
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 WS REGULATING
PLUMBING. GAS TEST
I HERN 5 EDEBY CERTAS REOUIFY THAT PR RL R STEREO A D/OR UTILITY CO. NOTIFIEyDLI ��.••�n a
CALIFORNIA OR THAT IRE ABY THE EGAL HER OFF,'AND NT ND TO C .Q.&, ?� •A.'/�'((Jq /I��.7� 51y, :,�,.`l'wjrii;!a�f
RESIDE IN THE ABOVE DES RI R ENT PROPERTY. - •r
FINAL
SIGNATU RE.
OF PERMITTEE _
PERMIT VALIDATION cK M.O. CASH '
PLAN CHECK VALIDATION CK. VM
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