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Home My WebLink About1714A (10) ... . . .._ . _.�..�.. ...- - -.._.. I76A667A • ... . ._. . . .. .. . , � _ .... � CE817fREV.II/78) LL APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES UILD�NG AND SAfETY ' 331a FORAPPUC.4NTTOF�LIINIPRINTORTYPEI BUILDING ADDRE55 NUh58ER FIXTUREOR�TEfA � FEE IOCALITY WATERCIOSET . . NEARESi BATN TUB � CROSSST. SHOWFR � ON'NER �, LAVATORY MAII _/ � Q—O ADDRESS ��D I �"� siNK W cirv tE�.rf. 6 1-1 ( !- DISHWASHER �f'U CONTRACTOR � ( I� CLOTHES WASHER � / ?�: � �/ �� ADDRESS ' �E��`r- � I� SWIMMINGPOOLRECEPTOR � CITV TEL.NO. ��—� LAWN SPRINKLER SYSTEM S7ATE / p� LIC. WATERHEATER � LICENSENO. ( ..S�O CIAS$� �� APPROVALS � DAT� a�ssicn et � GASSYSTEM �OU7LET5 OUTLETSOVER UNDERSLABWORK � � 5 PER SVSiEM ROUGH PLUM8ING � S � GASPIPiNG ' V ! GASVENT p� J HOT WATER HEATER, �� . o f PIUMBING FlXTURES �� L li GA$TEST y� Plancheckfee UTILIiYCO.NOTIFlED � Z I PLUMBiNG PERMIT ISSLIING FEE b ' � TOTAL FEE FINAL Q 6 1 Plan check oppl��cant ' PLAN CHECK VALIDATION . 4 r Name � . . �� Ic '�t Address ��: ' Ciry Tel.No. �r f ��, � ;�� `/1.!:Fi I XEREBV ACI(FOWLEOGE THAT I HAVE FERD iH15 APPLICATION AND STATE'� � ' THATTHE�BOVEISCORPECTJU,D�GREETOCOMPLYWITMALLCOUNttOP01NA4CE5'�. �h'1 • o e`) PM1D STATE lAWS REGUTATING PLUM91rvG. PERMIT VALIDATION � � I HEREBY CEFTiFY TNpT 1 PM FROPER�Y AEGISTERED�ND/OR LiCENSED AS ��, �'��e'�[�O(�� REOl11PED BY LOS ANGELES COIINTY ANp STATE OF CRLIFOHNIp OR THRT I AM iHE � ' LEGAL OWNEP OF.AND IHTENO TO HESIDE IN TNE�BOYE OESCFIBED PESIOENTIAL � L�i�Y��C'��G L FaOVERTY. � . P � /�, SiGNATURE //J � �•v C�•� 4 OFGERMITTEE �^ DISTRICT NO. M PROCESSE�Bv �. , � � 'I� "� INDUSTRIAL . 'I WASiE APPROVAI ' ' ,