HomeMy Public PortalAbout5201-5203 VILLAGE CIRCLE DR_Plumbing__ 76A667 (CE-817)- 5/73
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES %
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: FNEAREST
HARVEY T. BRANDT, COUNTY ENGINEER rn
wmle City
FOR APPLICANT TO FILL IN (PRINT OR TYPE)
NU BER FIXTURE OR ITEM @ FEE
OWNER Noel 3aldwin
WATER CLOSET 1.75
MAIL
BATH TUB 1.75 ADDRESS
f:
SHOWER 1,75 CITY "Cewnie City TEL. NO. 41,13,,3907
LAVATORY 1,75 CONTRACTORQwm Bros,L 11 .,�`
SINK 1.75 ADDRESS 4265 N, ; ,welt,µ+ .Ave,
DISHWASHER 1.75 CITY ti 4"Jonfe TEL. NO-4 r8
CLOTHES WASHER 1.75 STATE LICENSE NO. 2?1 �,1 CLASS "16,Q0
SWIMMING POOL RECEPTOR 1.75
LAWN SPRINKLER SYSTEM 1.75
DISTRICT NO. GROUP ZONE PROCESSED BY
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i 7,'
WATER HEATER 1.75 INDUSTRIAL v
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 NSPECTION RECORD w
J
OUTLETS OVER
5 PER SYSTEM .30
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Plan check fee See Reverse
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
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 GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REOU I 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.0. CASH