HomeMy WebLinkAbout1746A r __. __-- , _
I 76A667A �
' CE817(REY.11/7BJ . 11
APPLICATION FOR PLUMBING PERMIT
i COUNTY OF LOS ANGELES • UILDING AND SAfETY
i ' S�'- az, 33/a
FORAPPIICANTTOFILIINIPRINTORTYPEI bUIL01NG ,/� i
I ADDR[SS�'�-I� �vV
NUh18ER FIXTUREORITEM � F E
^ LOCALITV �
�L Vr'ATERCLOSEi �D
NEARESi
� BATHTUB � CROSS57
SHON'ER � OWYER �1 a-�1
IAVATORY MAI� /
AD�RESS
$INK � CITY TE.N . ���y�
f DISHIYASHER � CONTRACTOR �
�L
CLOTHESWASHER �� ADDRESS ���i"tj
i � $WIh1MINGPOOLRKEPTON
CIT TEL.NO. � — a�
� lAWNSPRINKLEFSYSTEM
� STAtE LIC. �
j WATERHEATER � LICENSENO. � CLA
GASSYSTEM s—OUTLETS � APPROVAlS �ATE tTon'S nnruaE
� OUilET50VER UNDERSIABWORK
' S PER SVAEM ROUGH PLUMBING L
F G/15 PIPING V
� GAS VENT p�
f HOi WATER HEATER Q
i PLUMBING FI%TURES �
GAS TESi N
�' Plan check fee UTILITY CO-NpTIFIEO Z
i
PLUMBING PERMIT ISSUING FEE$ �ljf
4� / ,�..,1 FINAI �
TOTA�FEE fo �v ,
I Plan check applicont PLAN CHECK VALIDATION
Name
� Address
City Tel.Na � �� ;�L.,`'�C
I XEAEBv ACkhOWLEOGE THAT I NAVE REhD THiS ACVLICATiON AND STATE � *�,',� � � � i �
THATTNFA9OYCISCOqpECT�N��GREETOCOMVLYWItH�LLCOUNTYORDIM1'ANCES i •
L F�OSTATELAWSREGYV.TINGFLUMBING. PERMITVALIDATION .
I NEREBY CEFTIFY TMRT I�M VftOPEflLY REGISTEPED�MD/Ofl LICENSEO AS I � �r�'.�'�^'i�j
PEOViqEU BY LOS ANGELES COIINTY AND STaTE OF CALIFORNIA OR TMAT I AM THE
LEGAL pW,vEP OG.RNO INTENp TO PESIOE IN THE�eOVE DESCRi9ED FESiDENiiAI , �^� � . � � .
PHOFEPTY.
SIGNATIIRE /- r ��� �C—r/�1
OFPERMITTEE �— .
DISTRICT NO. CESSED 6Y
( a a.�
� INDUSTRIAI � �
- NlASTEAPGROVAL ' . ,