HomeMy Public PortalAbout5131 SERENO DR_Plumbing__ ° APPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUILDING AND SAFETY
` • IL Department of County Engineer
County of Loa Angeles
WM J FOX COUNTY ENGINEER BUILDING
ADDRESS
CdeHATT D GRIFFIN Our T of BURowa ,p
LOCALITY 7, M IDIY
FOR APPLICANT TO FELL IN NEAREST CRJG/ G 6y rr
OWNER a4 DIBTpLCt"NO GRO I Z NE READY FO[ IN°P[RIoM
MAIL J1
ADDRESS
INDUSTRIAL
CITY TEL�NyO WASTEAPPROV L
PLUMBEARSA44dl E /%OORa` INSPECTION RECORD
ADDRESS IA .610, cC r �'
CITY O&AT6 TEL NO
C_
LICENSENO G�_ 3 — ief
NUMBER "PROF FI%TUR[OR ITEM F[°
WATER CLOSET (TOILET) 1;
BATH TUH
SHOWER
LAVATORY (WASH BASIN) C7 TC1'D n"-r TGa-c-
KITCHEN SINK a1 T'%ar OLPImc.
DISHWASHER
LAUNDRY TUB OR TRAY
341(A OR
CLOTHES WASHER
J
1 IJ 3AFn �.GOVG 001 [^ �IF3�f 1�
i n Let C'Z Prers+.tre 4esf ovAit
TOTAL NO V 0 Bo 00
oEF+►.-J APPROVALS AM
ATE IN ECTOR'S SIGNATURE
/ OAS SYSTEM OUTLETS 100 GO
DER SLAB WORK
WATER HEATER 100 O UN
ROUGH PLUMBING {'� 3 •����.
PERMIT s '60 I 1 00
GAS PIPING
TOTAL FEE 4.& Gas VENT
ILWIT BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
L COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
GEBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TESTD AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
NIA OR THAT I Aa THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
ED RESIDE TIAL PROPERTYURERMITTEE FINAL U
WILLIAM J FOX, COUNTY ENGINEER VALIDATION R A WOOD, CHIEF PLIO INSPECTOR
` AC0839ES SEP27 3 700
76A567 (CE 817)-4/72 `Z'
APPLICATION FOR PLUMBVIG PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDING
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY
FOR APPLICANT TO FILL IN IPRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET 1 75 OWNER
MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY TEL NO
LAVATORY 1 75 CONTRACTOR/
SINK 1 75 ADDRESS
DISHWASHER 1 75 CITY TEL NO ,
CLOTHES WASHER 1 75 STATE LIC qq
LICENSE NO 7 CLASS
SWIMMING POOL RECEPTOR 1 75
DiSTRCT fjl0 Gr 7T�NE RO ESSED BV
LAWN SPRINKLER SYSTEM 1 75 �USTgI LVC `(�
WATER HEATER 1 75 WASTE APAPflOVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30
O
W
L
Plan Check fee See RSV....
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
Plan check applicant APPROVALS DATE INSPECTOR t SIGNATURE
UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND !TATE THAT THEABOVE 13 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCE! AND !TATE LAW! REGULATING
PLUMBI HO GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS RIO ED BY LOS ANGELES COUNTY AND !TATE OF
CALIF O RH IA OR TNA AM TH LEGAL OWNER Of 49nINTENO TO
RESIDE IN THE ABOVW3CIIIq!!ID[ AL PRO R FINAL
SIGNATURE
OF PERMITTEE .�
PERMIT VALIDATION cK M 0 CASH
PLAN CHECK,�IIIDATION CK M O CASH ,
,pg587 5 D , 4.75-