HomeMy Public PortalAbout5216-5218-5220-5222-5224 VILLAGE CIRCLE DR_Plumbing__ ,. r,
76A667 (CE-817)- 5/73
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES , i
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
,HAKE CHECKS PAYABLE TO: FNEAREST
ILDING ,.� ,;,• � � ,r � fj
DRESS�)
HARVEY T. BRANDT, COUNTY ENGINEER CALITY
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FOR APPLICANT TO FILL IN (PRINT OR TYPE) OSS ST. r,• ,,
NUMBER FIXTURE OR ITEM @ FEE
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WATER CLOSET 1.75 �>l6• OWNER Noelf
MAIL
J BATH TUB 1.75 ADDRESS5:302 2-3dwin Ave
1 SHOWER 1,75CITY Trt YjV TEL. NO. 4�
r..� LAVATORY 1,75 CONTRACTOR J tl
SINK 1.75 ADDRESS 4265 N. Baldwin ;,'Yee
f, DISHWASHER 1.75 �J CITY1Q TEL. NO. t7
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f^ CLOTHESWASHER 1,75
I STATE 211 741 LIC C .,:0
LICENSE NO. CLASS '
SWIMMING POOL RECEPTOR 1,75
DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1.75 i_.. f
WATER HEATER 1,75 J 1INDUSTRIAL O
f WASTE APPROVAL c01
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GAS SYSTEM % OUTLETS. X1.75 % INSPECTION RECORD �
OUTLETS OVER 30
5 PER SYSTEM
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ J j3 00
TOTAL FEE f +` APPROVALS DATE INSPECTORS SIGNATURE
•P n check applicant UNDER SLAB WORK
ame ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
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
I CENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
LI FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
SIDE IN THE ABOVE DESC RIBEO RESIDENTIAL PROPERTY. FINAL
A,bIGNATU RE
OF PERMITTEE -
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
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