HomeMy Public PortalAbout5208-5210-5212-5214 VILLAGE CIRCLE DR_Plumbing__ 76A667 (CE-817)- 5/73 ."w...�.�T s rF' k. �` .
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO:
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Gt it
S HARVEY T. BRANDT, COUNTY ENGINEERY 1e vitFOR APPLICANT TO FILL IN (PRINT OR TYPE)NUMBER FIXTURE OR ITEM @ FEE T.
% WATER CLOSET 1,75 fi OWNER Noel 341dwin
MAIL
BATH TUB 1.75 / ADDRESS53 auldwin 4,
1-J SHOWER 1,75 j r CITY r TEL. NO. .Z
LAVATORY1,75 CONTRACTOR
SINK 1.75 i ADDRESS 420 N. 3aldwin Ave.
DISHWASHER 1.75 l CITY TEL. NO. .:`• }
f r C LOTHEj4ASHER 1.75 7 STATE 231 74 1 LIC ri16-20
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GRP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1.75 r ,.
WATER HEATER 1.75a
INDUSTRIAL
WASTE APPROVAL
U
GAS SYSTEM OUTLETS',; 1.75 INSPECTION RECORD w
OUTLETS OVER
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5 PER SYSTEM .30
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTORS SIGNATURE
lan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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
ICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF
ALI FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
ESIOE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK. M.0. CASH
PLAN CHECK VALIDATION CK. M.0. CASH