HomeMy Public PortalAbout5331-5333 SANTA ANITA AVE_Plumbing__ 7GA337 (CE-317) -'1179 ,C / U `i
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES 3-3 �L 3.3
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLETO: BUILDING ` �y� J
T
HARVEY T. BRANDT, COUNTY, ENGINEER ADDRESS
LOCALITY
v
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.. g,
WATER CLOSET 2.00 f '� Q OWNER �`rlGr S L.
MAIL
BATH TUB 2.00 o-� ADDRESS
SHOWER 2.00 CITY 0I"-'r s�� TEL. NO.C1C1 !Vfo
LAVATORY 2.00 CONTRACTOR L�/Q
SINK 2.00 () ADDRESS �/�jee
DISHWASHER 2.00 CITY r TEL. NO.
CLOTHES WASHER 2.00 STATE LIC
3
��l(�
SWIMMING POOL RECEPTOR 2.00 CLASS
LICENSE NO.
DIST ICT NO.JGROUPJ ZONE PR ESSED BY
LAWN SPRINKLER SYSTEM 2.00
WATER HEATER 2.00 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00 - INSPECTION RECORD CD
OUTLETS
5 PER S STTEMR .30 -
o
Cn
z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE s� APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant /Q, UNDER SLAB WORK 15'-16-7 ``
Name ROUGH PLUMBING .fir. �� �/ r�r�
Address GAS PIPING ° a
GAS VENT
City Tel. No.
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES �a•�v�j,yh� --�`� �.y�+ rr
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Gp Hof PLUMBING. GAS TEST
I HEREBY CERTIFY THAT 1 OPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED o
LICENSED AS REQUIRED BY L 5 GELES CO Y STATE OF ,
CALIFORNIA OR THAT I AM GAL WN fN'YBHb TO _
RESIDE IN THE ABOVE DESCRI RESIDE P ERTY. FINAL I '�> '�•�'11� ,
SIGNATU RE "r
OF PERM[TTE
PERMIT VALIDATION (.0 K. M,o: CASH
PLAN,CHECK VALID 'O CK. M.O. CASH
42 4 4PR 60 5 D 7 U..S Q A,�o
U� v