HomeMy Public PortalAbout5200-5202-5204-5206 VILLAGE CIRCLE DR_Plumbing__ 76A667 (CE-817) - 5/73
APPLICATION FOR PLIJ,MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER '
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING ^ r ;
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER ?c,
LOCALITY rempiec�ty
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
OWNER hT
,rte WATER CLOSET 1,75 ,;. ~�„,1,�` i
l- MAIL
BATH TUB 1.75 ADDRESS 53M :3taldwin Ave,
SHOWER 1,75 CITY To IE C,ity TEL. NO. 907
1 LAVATORY 1,75 f i CONTRACTOROwen 'ORe Plumbing,Inc,
s� SINK 1,75 ADDRESS +x265 N, aldwin Ave,
/ DISHWASHER 1,75 CITYMonte TEL. NO.! ( n
G CLOT((QS WASHER 1.75 7 STATE LIC � ,��
SWIM G POOL RECEPTOR 1.75 LICENSE NO. 2-Z1 1 CLA Crn4e)
DISTRICT NO. C UP _ZONE PROCESSED PY
LAWN SPRINKLER SYSTEM 1,75 ^ �I
WATER HEATER 1.75 INDUSTRIAL o
C
WASTE APPROVAL
GAS SYSTEM / OUTLETS 1.75 INSPECTION RECORD --1
OUTLETS OVER w
5 PER SYSTEM .30
0
w
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNAT'„•RE
Ian check applicant
UNDER SLAB WORK
Name 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 STATE LAWS REGULATING
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH