HomeMy Public PortalAbout5625 SANTA ANITA AVE_Plumbing__ 76A6¢7 (CE-817)-4/72 -
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APPLICATION FOR PLUMBI G PERM
u
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONBUILDING // r.
MAKE CHECKS PAYABLE TO. ADDRESS .� (p.Z J ,� T/4 iii ;Tip
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY re41ple ��.•j y�
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
�C
NUMBER FIXTURE OR ITEM @ FEE CROSS ST. .-
J' WATER CLOSET 1,75 OWNER 191171 f 3r" G;Ms . L&y
MAIL
BATH TUB - 1.75 S ADDRESS
SHOWER 1.75 CITY TEL. NO.
LAVATORY 1.j5 I CONTRACTOR �(/h�� �[/G a 4I $i`i✓p
O SINK 1.75 ADDRESS .�f OG'� ��: �.!`o✓>�t''S/�: /�
DISHWASHER 1.75 CITY Gy�N��'�'�Y TEL. NO. jV%rj 173
CLOTHES WASHER 1.75 STATE LIC
SWIMMING POOL RECEPTOR 1,75 LICENSE NO'.`L3'-t /q -3 C ASS
DISTRIC IY.Q� GROUP NE R D BY
LAWN SPRINKLER.SYSTEM 1.75 i!y
WATER HEATER 1.75 ��( rig INDUSTRIAL
WASTE A PROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER 30 C
5:PER SYSTEM .
W
H
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE Q/ 100
APPROVALS - DATE IN"ECTO.W.10AIrMATURF
Plan check applicant UNDER SLAB WORK
Name � Q,� j�`r� �S r+� ��..�] ROUGH PLUMBING.
Address
GAVPIPING
/gyp h; i�' =.vll s' ='� �cif
ljl/�.�1,• �;syr Tel. No. yy f 793 GAS VENT
City
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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATI-NG of
-
PLUMBING. .GAS TEST
1 HEREBY .CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF -
CALIFORNIA OR THAT 1 AM HE LEGAL OWNER OF, AND INTEND T0.
RESIDE THE ABOVE DES I SID I PER TY. FINAL
SIGNATT URE � `� �--
OF PERMITTEE. PERMIT VALIDATIO
o CK. M.0. CASH
PLAN CHECK VALIDATION CCK. M.O. CASH
U`iw^ 7 2 N -SSE'2 0 §9 D 2 0-00A-
LAw.9o9s;s 0G7 4 5 D 101D0,,! o
76A6u67 ('CE-81.7)-4/72 Q� O
APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS ANGELES '
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: FNEAREST
ILDING "'
DDRESS ���72✓ ���� /7`/✓i �R /���-
HARVEY T. BRANDT, COUNTY ENGINEER
CALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) Ross sT. ��K
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1.75 - OWNER
MAIL
�7 BATH TUB 1.75 ADDRESS
SHOWER 1.75 CITY TEL. N.O.
LAVATORY 1.75 CONTRACTOR DL A,Lw:c
SINK 1.75 4e �' ADDRESS 10473 5+.. A.•�, $r' ,�,-r1iTh/
G DISHWASHER 1.75 /10 CITY
Gy/s7�%'t/i C TEL. NO.yfll_f7r/3
CLOTHES WASHER 1.75 STATE LIC
LI
CENSE 3��- :� 9 3 CLASS G _STATE 10
SWIMMING POOL RECEPTOR 1.75
N GROUP NE R D BYE
LAWN SPRINKLER SYSTEM 1.75
J WATER HEATER 1.75 /
VAL
GAS SYSTEM 'OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER 0 CD
5 PER SYSTEM
W
O..
Vi
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 910 Q
APPROVALS DATE, INS CTOR'S IGNATURE
Plan check applicant UNDER SLAB WORK
7Al
Name A ab6;y.es ��y d •b T ROUGH PLUMBING
Address .S
,00'j U o(- /y40{ S,__ GAS PIPING
city A,/Ff;Tr' r�.- Tel. No. Tifsf �q7 GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 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 I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE L GAL OWRER. OF, INTEND TO
RES IDE IN THE ABOVE DESCRIB R IDENTIPRO RTY.
'' FINAL
S I G NA TU RE `OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK M.O. CASH
95
9.:0934 OCT 4 5 D 90.50- q