HomeMy Public PortalAbout5500 ROSEMEAD BLVD_Plumbing__ 76^667 ICE-4171 - 1/74 - t/ /� /2 - --_ _
APPLICATIONVOR PL,yMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION Bu1LDINc
MAKE CHECKS PAYABLE TO ADDRESS SS qS771
HARVEY T BRANDT, COUNTY ENGINEER LOCALITY L� dl jI
FOR APPLICANT TO FILL IN (PRINT OR TVPEI CROSSST RO NUMBER FIXTURE OR ITEM O FEEWATER CLOSET 2 OO OWNER A " P 9MAIL"'B 200 tJ ADDRESS /200CITY TEL NO.BOO 1 LAVATORY 200 Z — CONTRACTORLCSINK 200 3 ADDRESS DISHWASHER 200 CITY TEL N0
CLOTHES WASHER 200 STATE LIC bb
SWIMMING POOL RECEPTOR 20 LICENSE NO,97S9CLASS
DISTRICT N04GROUPI ZONE CESSO BY
LAWN SPRINKLER SYSTEM 200 .Uty P C
WATER HEATER 200 IND
wAYMUOVAL k, •�AVp/l 6 3
OAS SYSTEM OUTLETS 200 INSPECTION RECORD o
OUTLET OVER I Q [D
5 PER SYSTEM 30 i ' w 1 i� J r Vl4-- IJ^ � Old
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Plan Check lee See Rexene
PLUMBING PERMIT ISSUING FEE 6 r
TOTAL FEE
APPROVALS GATE INSPEFTOA a eIGNAruRG
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 [TAT[ THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDI MAN CO AND
STAT[ LAWS REGULATING
PLUMBI MO GAS TEST
I HERCBY CERTIFY "AT 1 AM PROPERLY REGISTERED ANO/OR UTILITY CO NOTIFIED
LICENSE AS REOUIR[0 BY LOS ANGELES COUNT AND STATE 01
CALIIORNIA OR THAT I AM THE LEGAL OWNER XD TO
RESIDE IM THE ABOVE DISCRIM90 REBID MTI OPER FINAL mil
SIONATU RE
OP PERMITT E@�
PERMIT VALIDATIONEK M 0 CASH
PLAN CHECK VALIDATION CK M 0 CASH
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