HomeMy Public PortalAbout5319-5321 SANTA ANITA AVE_Plumbing__ 76AG67 (C6-817) - 1/75
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES 5 3
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO. BUILDIRENG
ADDSS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM 2.O CROSS ST. LAY
j FEE rd S'
WATER'CLOSET OWNER/ MAIL
BATH TUB 2.00 Q ADDRESS
2 SHOWER 2.00 CITY 1 d TEL. NO.
LAVATORY 2.000_ CONTRACTOR
SINK 2.00 d—Q ADDRESS #f
DISHWASHER 2.00 CITY �y�.� tdj�7 TEL. NO. !�
CLOTHES WASHER 2.00
STATE
LICENSE NO. 6 f�� CLASS
SWIMMING POOL RECEPTOR 2.00
DISTRICT NO.GROUPO P O SED BY
LAWN SPRINKLER SYSTEM 2.00 �O�
WATER HEATER 2.00 WASTE(f-6 INDUSTRIAL
APPROVAL
GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD '"
5 PER-OUTLETSYSTEMS
R .30
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE'S
TOTAL FEE
�+— APPROVALS DATE INSP TOR'S SIGNATURE
Plan check applicant �OyJ UNDER SLAB WORK r/7-
Name
rName ROUGH PLUMBING Q.V
Address
GAS PIPING ` !" '�~ ✓!
City Tel. No.
GAS VENT ,, , �fr /6dT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE. THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING_FIXTURES •'�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TESTS
PLUMBING. e
1 HEREBY CERJTHATPROPERLY REGISTERED AND/OR UTILITY. CO. NOTIFIED �+' �P LICENSED AS REQANGELES' COU AND STATE OFCALIFORNIA OR THEGAL WNE F, A IRYEND TO
RESIDE IN THE ABOEBID P P TY. FINALSIGNATURE
OF PERMITTE
PERMIT VALIDATION CCK.- ' M.O; CASH
PLAN CHECK VALID I N CK. M.O. CASH 4 2 6 L APR ;�O 5 0id
7 0.5 0 A
yQ.