HomeMy Public PortalAbout5322 WELLAND AVE_Plumbing__ 4.76A657 fC.:€-817)-4/72
APPLICATION OR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONBUILDIl'�
MAKE CHECKS PAYABLE TO: ADDRESS ,y +� I` p A f
ADDRESS �` s"�
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @FEE r
WATER CLOSET 1 78 OWNER
11 BATH TUB 1.75 MAIL
ADDRESS (�+
SHOWER 1,75 CITY 64 TEL. NO.
LAVATORY y dad 1.755 CONTRACTOR `i��
SINK 1.75 ADDRESS`�. 4<—
It DISHWASHER 1.75 CITY VJ— f (�/ TEL. NOV.3�3-�7dr�
CLOTHES WASHER 1.75 -✓ LICENSE NO. '3.1"J 'Z LIC
CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP NE FROG SSED Y
LAWN SPRINKLER SYSTEM 1.75 �
WATER HEATER 1.7512 INDUSTRIAL
WASTE.APPROVAL
GAS SYSTEM .6—OUTLETS 1.75 INSPECTION RE RD v
OUTLETS OVER 30 O
5 PER SYSTEM
d�J✓ ` a-
h
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE If
APPROVALS DATE IN EC TOR'. SIGNATURE
Plan check applicant UNDER S AB Y#ORq
Name RO
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
_
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES w /"' f.
WITH 'ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/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 OESCRIB RESI DENT! .t ROPE TY. ,
FINAL Z�3''� r
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH V\A
-45
LAP, 18 6 273 JUN 26 5 D 3 1 ,00N Q