HomeMy Public PortalAbout6284 SULTANA AVE_Plumbing__ 76A667 (C E-81 7)-8-71
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
LOCALITY -�� J J � I f J4
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1.75 '
MAI L
BATH TUB 1 75 ADDRESS 'S !
SHOWER 1 75 CITY TEL. NO.
LAVATORY 1 75 CONTRACTOR V(� ✓i ,
SINK 1.75 ADDRESS
DISHWA HER 1.75 = CITY .f �,;;r/y` TEL. NO��y'r'
CLOTHES WASHER 1 75 STATE LIC
LICENSE NO. 'l ✓ CLASS 1"✓
f SWIMMING POOL RECVFTQR, 1.75 f�'
DISTRICT NO. GROUP ZONEPROCESSED BY
LAWN SPRINKLER SYSTEM 1,75 7--
WATER HEATER 1.75 INDUSTRIAL O
WASTE APPROVAL V
i� GAS SYSTEM OUTLETS 1 75 17INSPECTION RECORD W
J
OUTLETS OVER 30 {L
5 PER SYSTEM
a
. a
a
O
a
W
Plan check fee See reverse F"
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
Tel. NO. GAS VENT
City HOT WATER HEATER
I 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 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 LEGAL OWNER OF, AND INTEND TO
RESIDE �IN�TH�EBOVE DESCRIBED RESIDE TIAL ROPEIR FINAL
SIGNA .fj' /� /
OF P ( !
PERMIT VALIDATION CK. M.O. CASH
I
N CHECK ALIDATION CK. M.O. CASH
76A667 (CE-817)-B-71
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING J 1
ADDRESS i,�i
LOCALITY 4-
TB
N i C-1 4
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. U IV ,✓
NUMBER FIXTURE OR ITEM @ FEE _ /�
OWNER � '; i i:.T ,y -'L `-
WATER CLOSET 1.75 MAIL
BATH TUB 1 75
ADDRESS.
SHOWER 1 75 CITY ( r't) J'r j TEL. NO.
LAVATORY 1 75 CONTRACTOR %'✓ ✓ 1 ?� ^;y.G
SINK 1.75 ADDRESS i ,- - ,) /v C"
DISHWASHER 1 75 CITY -I ) Cjr,., K4 f� TEL. NO. --'C)l- YJ
CLOTHES WASHER 1 75 STATE 9 I , LIC
LICENSE NO. ` CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP ZONE I CESSED BY
LAWN SPRINKLER SYSTEM 1 75
C.
WATER HEATER 1 75 INDUSTRIAL Q
WASTE APPROVAL V
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD W
J
OUTLETS OVER 30 1!.
5 PER SYSTEM
ice
1!3'1 �) ��• tlC
0
a
Plan check fee See reverse F'
PLUMBING PERMIT ISSUING FEE $ 3 00 --
TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant / { UNDER SLAB WORK
Name f`1�l 1--t ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
I 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 S:14�E LAWS REGULATING
PLUMBING. `itw.,•.- 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 I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE A, V SCSR�I BED (2 E�)ENT'1`gL)P5O ERT FINAL
SIGNATURE ! /, ' 1. L/J J1„J� � V
OF PERMI TTE
PERMIT VALIDATION CF. M o. CASH
PLAN CHECK VALIDATION CK M O. CASH
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