HomeMy Public PortalAbout9027 RANCHO REAL RD_Plumbing_1974-04-22 76A667 (CE-817)-.5/73 ��PLUMBINGPERMITAPPLICATION F
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: F_ADDRESS
NG ��yyryry
HARVEY T. BRANDT, COUNTY ENGINEER TYFOR APPLICANT TO FILL IN (PRINT OR TYPE) TST.
NUMBER FIXTURE OR ITEM @ FEE r
WATER CLOSET 1,79 :OWNER
MAIL•
BATH TUB 1,75 ADDRESS e
SHOWER 1,75 CITY TEL. NO.
LAVATORY 1,75 CONTRACTOR _
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY — TEL:N0e7vr
CLOTHES WASHER 1.78 STATE ��JJ"`r LIC
C`�r - Com-`
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. QI�fCLASS
DISTRICT NO. GR UP NEIr PRO SS BY
LAWN SPRINKLER SYSTEM 1.75 �G /I ,
(1
WATER HEATER 1.75 INDUSTRIAL v(
WASTE APPROVAL
GAS SYSTEM OUTLETS 1..75 INSPECTION RECORD O
OUTLETS OVER v
5 PER SYSTEM .30
O
W
CL
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
.APPROVALS DATE INS P.E CTOR'S SIGNATURE
Plan check applicant. UNDER SLAB WORK
Name _�� ROUGH PLUMBING
L
ss _� GAS PIPING
��. Tel. N / GAS VENT
HOT WATER HEATER
REBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
LL COUNTY ORDINANCES AND STATE LAWS REGULATING
NG. GAS TEST
REBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
D AS 0UIRED BY LOS ANGELES COUNTY AND STATE OF
RNIA OR AT 1 AM THE LEGAL OWNER OF, AND INTEND TO �/-� �/f(f
IN THE AB DESCRIBED RESIDENTIAL PROPERTY. FINAL
TURETU RE TTE - _
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.G. CASH
6 -30--APIZ 22 5 D 6.5 0