HomeMy Public PortalAbout6355 SULTANA AVE_Plumbing__ .7SA667A ICE 8178)-11/76
APPLICATION .FOR*.PLUMBINGPERMIT
BUI G AND SAFETY r,,jP1s10N
FOR APPLICANT TO FILL I_N(PRINT ORTYPE) BUILDING
—5 /v
NUMBER FIXTURE OR ITEM ® FEE ADDRESS i7 fT
WATER CLOSET LOCALITY
NEAREST
BATHTUB CROSS ST 4.1-&
SHOWER OWNER
LAVATOr MAIL
RY ADDRESS
SINK CITYG TEL.N`;2p-7—
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM
STATE LIC.
'WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS' DISTRICT NO. G P ONE OC SE BY
OUTLETS OVER Is— I
r I
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL u
INSPECTION RECORD f
H
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check.applicant .40
APPROVALS DATE INSPECTOR'S SIGNATURE
L
UNDER SLAB WORKss ROUGH PLUMBING
Tel.No. GAS PIPING
EREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE GAS VENT ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
TE LAWS REGULATING PLUMBING. HOT WATER.HEATER
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
D BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THATI AM THE GAS TEST
WNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
Y. UTILITYCO.NOTIFIED
URERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
tiAUG 17 , 5 D .50e
- 254 . .
®s
7sAsfFtJ_(c,E�917)-8-71
t:_, APP1 ,KATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Q.
BUILDING AND SAFETY DIVISION BUILDINGADDRESS FTEN
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST ,t
CROSS ST. C`rE
NUMBER FIXTURE OR ITEM ® FEE
OWNER
WATER CLOSET 1.75 MAIL
BATH TUB 1.75 ADDRESS
SHOWER 1.75 j CITY ° .
LAVATORY 1.75 0 CONTRACTOR
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY .
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO.. CLASS _.
SWIMMING POOL RECEPTOR 1.75
DISTRICT�NO. - ZONE M
ESSED
LAWN SPRINKLER SYSTEM 1.75 5 �s.�, (fit,
WATER HEATER 1.757
INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM .30 Z
O
V
W
d
• VJ•
0
Plan check fee. See reverse.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 17
APPROVALS DATE PECTOR'3 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name f y /L ROUGH PLUMBING
Address 9—C 501—ANAM
GAS PIPING
City / r /�Q° Tel. No. GAS VENT
!Y LY /��C L �3 OT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
A,KD—STATE THAT THE ABOVE IS CORRECT AND AGREE TO.COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
v PLUMBING.
GAS TEST
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
. LICENSED AS REG UIRED BY LOS ANGELES COUNTY AND STATE OF -
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF; AND INTEND TO
RESIDE IN THE ABOVE DESCRIBE RESIDENTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION K. M.O. CASH
'PLAN CHECK VALIDATION CK. M.O. CASH
,s 5 ;5 0 (7r-%i AR 14 5 D 1 8.7 5~ co