HomeMy Public PortalAbout9703 VAL ST_Plumbing__ 76AS67 (CE-617)- 5/79
APPLICATION FOR PLU ING PMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDINGc
ADDRESS 9703
HARVEY T BRANDT, COUNTY ENGINEER LOCALITY T a City
FOR APPLICANT TO FILL IN (PRINT OR TPEI NEAREST
NUMBER FIXTURE OR ITEM ® FEE---)�
CROSS ST
WATER CLOSET 1 75 V OWNER Dick Boren
M IL
BATH TUB 1 75
ADDRESS1620 Melanie Laze
SHOWER 1 75 CITY Arcadia TEL NO 4455-117/
LAVATORY 1 75 CONTRACTOR Oren Bros, VID / C•
SINK 1 75 ADDRESS 42265 He Baldwin Agee
DISHWASHER 1 75 CILICENSE
TEL NO 1 �QO/r�
B
CLOTHES WASHER 1 75 STATE L CENSE NO 231 C g6..WLIC $
SWIMMING POOL RECEPTOR 1 75
DIST�}CT NO GROUP NE FR ESSE BY
LAWN SPRINKLER SYSTEM 1 75 UU$$77GII LLO D f
WATER HEATER 1 75 WASTE RV
GAS SYSTEM & OUTLETS 1 75 INSPECTION RECORD 4�
OUTLETS OVER
5 PER SYSTEM 30JAPPLICATION
_ ��F CC
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H
2
Plan check fee See ReV•,Se
PLUMBING PERMIT ISSUING FEE S 0
TOTAL FEE ('J
APPROVALS DATE C INSPECTOR e1rH•Tu[c
Plan Check applicant UNDER SLAB WORK
NeR1e ROUGH PLUMBING
AddFI958 --V-
GAS PIPING �Tr
City Tel NOGAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THISIONAND STAT[ THAT THE ABOVE 16 CORRECT AND AGR! LY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STAT! LAWSI NOPLUMBINGGAS TEST
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTOR UTILITY CO NOTIFIEDLICENSED AS REQUIRED BY LOS ANGELES COUNTY AOICALI IORNIA OR THAT I AM THE LEGAL OWNER OF ATORlDIOE IN THE ABOVE C [0 RESIDENTIAL OPEFINAL Q�S'-�f
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION OCKM O CASH
PLAN CHECK VALIDATION CK M 0 CASH /1
1 4OPJU 1 5 0 1/ . ' 2 430!96