HomeMy Public PortalAbout5809 ROWLAND AVE_Plumbing__ 76A667 (CE-817) - 1/75l/
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FBUILDING
MAKE CHECKS PAYABLE TO: DRESS
HARVEY T. BRANDY, COUNTY ENGINEER CALITYFOR APPLICANT TO FILL IN (PRINT OR TYPE) AREST
OSS ST. j
NUMBER FIXTURE OR ITEM @ FEE
WATER OWNER CLOSET 2.00 E-bb
MAIL
BATH TUB 2.00 ADDRESS )
SHOWER 2.00 CITYy� TEL. NO.
LAVATORY 2.00 CONTRACTO
1
SINK 2.00 ADDRESS
DISHWASHER 2.00 Cln TEL. NO. 4/4/
'
CLOTHES WASHER 2.00 STATE / LIC
SWIMMING POOL RECEPTOR 2.00 LICENSE NO. CLASS
DISTRICT NO.GROUP ZpNE PRO SSED BY
LAWN SPRINKLER SYSTEM 2.00 U✓ t
WATER HEATER 2.00 INDUSTRIAL
WASTE APPROVAL i
GAS SYSTEM OUTLETS 2.00INSPECTION RECORD U
OUTLETS OVER
5 PER SYSTEM .30 O
U
CkZ
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
JIL
TOTAL FEE 7, (,
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ •THIS APPLICATION HOT WATER HEATER
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 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DES
C/RIS
ED RESIDENTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION 1-CK M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
U 7.5 U _
76A667 (C6-817) - 1/75 , i r.p1 L CI �LI
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES l
DEPARTMENT OF COUNTY ENGINEER /
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS , (3A Ii) )( ' ,
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
WATER CLOSET
2.00 OWNER �86b
MAIL
BATH TUB 2.00 ADDRESS �) n ,
SHOWER 2.00 CITY' -yl 1 TEL. NO. ,7_
LAVATORY 2.00 CONTRACTO F '
l
SINK 2.00 ADDRESS jQ )
DISHWASHER 2.00 CIT1r� i/. TEL. NO.
CLOTHES WASHER 2.00 STATELICENSE N0. /! CLASS
LIC
SWIMMING POOL RECEPTOR 2.00
DISTRICT/N�O.GROUP pNE PROCESSED BY
LAWN SPRINKLER SYSTEM 2,00 SVU ` (J" ( / �J '
WATER HEATER 2.00 INDUSTRIAL J_ ��IJJJ���
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00 a
INSPECTION RECORD v
OUTLETS OVER
5 PER SYSTEM .30 O
1 AJiS 9010
Cn
• z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 61151)
TOTAL FEE Z'}
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant 11 UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. _ GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THEABOVE 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 t
UTILITY CO. NOTIFIED
LICENSED AS REOUIREO BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AN-6 fR7900 TO ('
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PkOPERTY. FINAL 'Lp f6 ��"
SIGNATURE /t 1 �.a / 4.- (\ y
OF PERMIfi-EE I i SLYl1-.,Y a +
PERMIT VALIDATION cK. M.O.. CASH
PLAN-CHECK VALIDATION CK. M.O. CASH 5 D r-f.5
3 9 lb-"PP u