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HomeMy Public PortalAbout5335 SANTA ANITA AVE_Plumbing__ 7GA667 (CE-617) - 1/75 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES2 DEPARTMENT OF COUNTY ENGINEER .`� >,7c, BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS 2 '10'L HARVEY T. BRANDT, COUNTY ENGINEER4 LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. t T' NUMBER FIXTURE OR ITEM 0 FEE WATER CLOSET 2.00 OWNER J+7 O S ��►et r MAIL � BATH TUB 2.00. ADDRESS &5 CJ SHOWER 2.00 CITY ' ,A-7 ��� TEL. NO. (j LAVATORY 2.00 / �-p CONTRACTOR SINK 2.00 ADDRESS O1& 3 DISHWASHER 2.00 CITY ��r L TEL. NO. CLOTHES WASHER 2.00 STATE LIC LICENSE NO. 70 © � CLASS o SWIMMING POOL RECEPTOR 2.00 DISTRICT NOGRO . UP E ��B� f LAWN SPRINKLER SYSTEM 2.00 �ONE R SSEDY r WATER HEATER 2.00 INDUSTRIAL . _ WASTE APPROVAL or GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD v OUTLETS OVER 5 PER SYSTEM .30 �� 'ZC Q1vbW-:r&+ &V d O U ly a Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE _ APPROVALS DATE INSPE-CITOR'S SIGNATURE Plan check applicant ] S (� UNDER SLAB WORK 4 —4'?- Name,.; ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST %0 1-41-W 1 HEREBY CERTIFY THAT I AM PR ERLY R TERED AND/OR UTILITY CO. NOTIFIED /pZ LICENSED AS REQUIRED BY LOS A LES.CO AND STATE OF CALIFORNIA OR THAT I AM THE L 0 OF, AN5 MTENb TO RESIDE IN THE ABOVE DE IS S TI PROPERTY. FINAL i SIGNATURE OF PERMITTEE PERMIT VALIDATION11,CK.' M.0; CASH PLAN-CHECK VALID ION CK. M.O. CASH 42 Jo-APP Z0 5 U 4 6.5 0 a��