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Home My WebLink About1728A � , . � i 76A667A � CE 817(REV.11/78) �F'F'L�[CA`T'1 O t!1 F�►Fd P'L.,LI IIVI �l l'�1 C,� F'E R M IT COUhITY OF 6.05 AsNGElES �UI101NG AND SAFETY .t,�- -- .��✓� FOR APPUCAN?TO FILL IN(PRINT OR TYPEi � ADDRESS ,;ye ��L> �. � �� "--'%'" NUMBER FIX?URE OR ITEM Q FEE � �� „� ..00ALITY � WATER CLOSE" �,'✓`�' V'cAREST /'.% _:� BATH TUB � � �'�OSS ST �'"�-'�;� � SHOVJER OWNER �,,R."a..'�`�,��.,,r �•�„�._,�, i,�--%�„� �/ LAVATORY ^ �-� qDDRESS<��/ Gc"�' °'-'�-�-�"�G'C/� SINK � .� � CITY �0„i��"'�.i,�.,,Z,,,,��,�',ri TE�N . ��a'J��P ��. � DISHWASHER „� G'�2� �ONTRACTOR, � 1 CLOTHES WASHER dG%"7.� qDDRESS��'�J � SWIN,MING POOI RECEPTOR ,* CI I'Y�_..,i'7...,��L-�-z�-sL�/ya� TEL.NO.��.�•-� ,p LAWN SPRINKLER SYSTEM / STATE J LIC. �.....- WATER HEATER � JCENSc NO. ,� ��j� CLASS � GA�SYSTEM �OUTLETS � �T"� APPRO'JALS DATE I PE6�oR s Sic�ry.�,, OUTLETS OVER UNDER SLAB WCRK ��' ,,,. °_-�` " � F � " r`"� "� 5 PER SY57EM ROUGN PLUfA31NG � '� j �.'`�� '� � - �� GAS PIPING � GAS�/ENT �; HOT WATER HEATER � Pi.�JMBING FIKTURES �g.,,,.^ GAS TEST �9 Plan check fee �riuTvco.NoriFiEc ,' P� rf PLUMBWG PERMIT ISSU'NG FFE$ � � i TOTAL FEE �'"�' � FINAL � ' 1`� C�) :'� e� �' G..w.,�-- -�....._...- .. Plan check applicant PLAN CMFCK VALIDATION ` Name Address Ciry Tel.No. �: i �l ; .^ �, I HEREBY ACKNOWLEDGE THAT I HAVE READ TH'��S APP��_IC.4TtON ANl?S'ATE � _ THATTHE AFOVE IS CORR'cC7 AND AGREE TO COMPLV WITH ALL COUNTY'ORDINAM1'CE5 � �;��°' � �� '`��'� U .. � � AND STATE LAWS REGULAT!NG PIUMBING. P�RMIT VALIDATION �� .'' &n '_ `' � I.� . 1 HEREBY CLHfIFY THPi I AM PHOPERLY NEu15TERED AN�JiOR LICENSE�AS = ' .��-�s, ,. ' . REQUIRED BY LOS ANGFLES COUNTY ANO STATE OF CALI�OPNIp OR THATIAI.ITHF . LEGAL OWNER OF,AND INTEN�TO RESIDE IN 7HG A�OVE DESCRI�ED RESIDENTIA��_ . +,�.✓z ;^� ��, ;'��!� . ' PROPEP,TY. � � � �� . SIGNATURE � �� i,i.�Y,`""'1/��.�."�'. . OF PERMITTEE DISTRICT NO. PROC=SSED BY ez�' � ..,�" INDUSTRIAL � � - WASTE APPROVAL