HomeMy Public PortalAbout5349 VILLAGE CIRCLE DR_Plumbing__ 76A667 (CE-817)- 5/73
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF' LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Recreation Room
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING 5349 Village Circle Dr.
ADDRESS
HARVEY T. BRANDY, COUNTY ENGINEER LOCALITY 0 Temple City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST -
NUMBER FIXTURE OR ITEM FEE CROSS ST.
WATER CLOSET 1,75 OWNER Baldwin CO
MAIL
5302 Baldwin Ave
ADDRESS ®
BATH TUB 1.75 '
SHOWER 1,75 CITY _ TEL. N0.
LAVATORY 1.75 S� CONTRACTOR Owen BreS• PlUbb3.ngs Zn6s
SINK. 1.75 •'� ADDRESS ' 65 N• Baldwin Avee
DISHWASHER 1.75 CITY in Mont e TEL. NO. ko,,Wa
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO. LASS
SWIMMING POOL RECEPTOR 1.75
LAWN SPRINKLER SYSTEM 1,75 DISTRICT NO. G OUP ZONE PROCESSED By
WATER HEATER 1.75 S INDUSTRIAL
WASTE APPROVAL C
GAS SYSTEM OUTLETS 1.75 .S INSPECTION RECORD v
OUTLETS OVER
5 PER SYSTEM 30 C7
Cn
op
" Cn
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
Plan check applicant APPROVALS DATE 'INSPECTOR'S SIGNATUgE
UNDER SLAB WORK 9 ®,G —*74
Gh,� �:�►_.T-,✓
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
�•��•�7�'- / i ����
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
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DE IBED RESIDENTIAL PR ERTY.
FINAL
SIGNATURE
OF PERMITTEE
PERMIT V I ATION D
IOM.O. CASH
PLAN CHECK VALIDATN CK. M.O. CASH
D V ri Cu 4e.L u G U.-) U ty�c
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76A667 I,CE-817) - 1/75 ,} '
APPLICATION FOR PLUMBI'VG PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS /
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
't
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. .. r l !
NUMBER FIXTURE OR ITEM @ FEE /
OWNER
WATER CLOSET
2.00
MAIL
BATH TUB 2.00 ADDRESS
SHOWER 2.00 CITY ` f.. < TEL. NO.
LAVATORY 2.00 CONTRACTOR r
SINK 2.00 ADDRESS
DISHWASHER 2.00 -
CITY r,. TEL. NO. !�7
CLOTHES WASHER 2.00 STATEr _ "/ LIC
LICENSE NO. ' / / 7 CLASS t,
SWIMMING POOL RECEPTOR 2.00
DISTRICT NO.GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM p-pp -' <, ,:r
WATER HEATER 2.00 INDUSTRIAL CD U
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD LLJ
OUTLETS OVER u.
5 PER SYSTEM .30
CD
O.
La!
F—
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 1
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 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PA PERTY. FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
0 4 r �. _ _ -i V.J V •" ;