HomeMy Public PortalAbout5603 SULTANA AVE_Plumbing__ TGASST (Cwn) - UTE _
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
Al-
BUILDING AND SAFETY DIVISION BUILDING -
MA KE CHECKS PAYABLE TO ADDRESS j (
HARVEY T BRANDT, COUNTY ENGINEER LOCAL(
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM ® FEE CROSS ST
WATER CLOSET 200 OWNER L E JSY
MAIL
BATH TUB 200 ADDRESS
SHOWER 200 CITY TELNO
LAVATORY 200 CONTRALTOSINK 2 DO ADDREDISHWASHER 2 00 CLOTHES WASHER 2 00 ATE LIC �pLIC ENS NO Q47
CLASSSWIMMING POOL RECEPTOR 200
DISTRICT NO OFIOjjP NE /►RQCELAWN SPRINKLER SYSTE 2 00 (�S7�g1p� JWATER HE 200 O WASTE APPROVALGAS SYSTEM OUTLETS 200 INSPECTION RECORDo
OUTLETS OVER [�
5 PER SYSTEM 30
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Plan check fee So. RRNe,[R
PLUMBING PERMIT ISSUING FEE B
TOTAL FEE
APPROVALS DATE IMRP[croN a elaMAru R[
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEOS[ THAT I HAVE READ THIS APPLICATION
AMD STATE THAT THEABOVE 13 CORRECT AND AOR[[ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLOMBIMG GAS TEST
I MEREST CERTI Py THAT 1 AM PROPERLY REGISTERED AMD/OR UTILITY CO NOTIFIED
LICENSED AS NEOIIIREO SY LOS ANGELES COUNTY AND STATE OF
CALI PERMIA OR THAT I AM THC LEGAL OWNER OF, AND INT[ TO
RESIDE IN THE ABOVE DESCRIBED RE P PERTY FINAL
SI ONATU RE 17
OF PERMITTE
PERMIT VALIDATION cK M D CASH
PLAN CHECK VALIDATION CK M o CASH
1 6 9PIlrT 16 -5 D 7S 0 At'6