HomeMy Public PortalAbout9818 VAL ST_Plumbing__ 76AG57 ICE-8171 4/72 1
APPLICATION FOR PLU;ABING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION Q
M1IA RE CHECKS PAYABLE TO BUILDING
ADDRESS r
HARVEY T BRANDT. COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM ® FEE r�
WATER CLOSET 1 75 OWNER
MAIL S
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY TEL NO
LAVATORY 1 75 CONTRACTOR QG
SINK 1 78 ADDRESS
DISHWASHER 1 78 CITY TEL NO��
CLOTHES WASHER 1 7S STAT LIC
LICENSE NO CLASS C--
1
joy
SWIMMING POOL RECEPTOR1 75
DISTRICT NO UP NE C
LAWN SPRINKLER SYSTEM 1 75 0
UI�SSTpplIrLL
WATER HEATER 1 75 WA$TETAPAPhOVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD
OUTLETS OVER
8 PER SYSTEM 30 E.OE.....
C]
W
yd
Z
Plan check tee See Re",Se
PLUMBING PERMIT ISSUING FEE S 3 00
TOTAL FEE
APPROVALS DATE INEPEGTGR B eIrNATUR[
Plan check IICBnt UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City �_ Tel No GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE IB CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS AS TEST
I HEREBY IFY THAT I AM PROPERLY REGISTERED ANO/OR GTI IYr0 NOTIFIED
LICENSED AS R R!D By
LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR A I DAL OWNER OF AND INTEND TO O
RESIDE IN THE AS (BED RESIDENTIAL PROPERTY
FINAL .-U• 76
SIONATU RE
OF FERMI TEE
PERMIT VALID N cR 0 CASH
PLAN CHECK VALIDATION CK M 0 CASH
�( 1 7 6 973 JUN 1 5 D 825-
a