HomeMy Public PortalAbout5915 PRIMROSE AVE_Plumbing__ 76A667 (CE-817)-8-71 ,
APPLICATION FOR PLUMBING PERMIT {�
COUNTY OF LOS ANGELES'
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 'BUILDIADDRESS / v�
ADDRESS
LOCALITY i
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1.75
MAIL
BATH TUB 1.75 ADDRESS f
SHOWER 1.75 CITY / TEL. NO. �� �,�'
CONTRACTOR /
LAVATORY 1.75 L/
SINK 1.75 ADDRESS ' l
DISHWASHER 1.75 CITY „/ &I— TEL-NO. '
CLOTHES WASHER 1.75 STAT LIC
SWIMMING POOL RECEPTOR 1.75 LICENSE N0. CLASS M
DISTRICT NO. GR UP ONE ESSED BY
LAWN SPRINKLER SYSTEM 1.35 r` j
WATER HEATER 1.75 INDUSTRIAL A.
.WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER .30
5 PER SYSTEM
V
W
0.
H
Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name 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
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
RE91DE IN THE ABOVE DESCIBED RESIDENTIAL PROPERTY FINAL f..1
SIGNATURE
OF PERMITTEE ®� Afj 44.7.5
PERMIT VALIDATIONM.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
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