The URL can be used to link to this page

Home My WebLink About1731A _ I 76A667A ... . . . . . . . . . . - � CE Sl7{REV.iI/78j A P P L,�C AY'I C�� IF t�l� P L.1J dV[ �I N C� F�E R t�V91 T COUNTY OF!OS ANCELES I�l��rCt9NG Af�ID SAFETY �`�" ,�/-' �i ,.s.�'�+'� FOR APPLICANT 70 FILI IN IPRINT OR TYFEI ADORE$S� ��„�r �-��-�''��..�$� NUMBER fiXTURE OR ITEM Q PEE WA7ER CLGSET c.�' � �CCALITI'�,��r,��.a,q_,�-�,,,,,,,�� /'��,.L1 N°ARESi � c '' BA"HTUB '� {;�'}; �ROSS.T SHOVd"cR O�h'NER �r'��,�„fjy.,�h-� MA1L �,,� _,� / LAVATORY � �j ADGRESS�`�� c-'' �'�' �/�/i''~�,Y�/-�..� �� G°�"J�--�"'" ' S1'vK �,,��$7 CiTY ��,,a.�, � � TE�NO.�"'6:'�� . �,�' , DISHWASHER � � CONTRACiOf{:,�"j�.=^''�'u'`� . �¢'� . • �..c.ss j CLOTHES\h'ASHER „�-'� ADGRcSS /�`' �+ '^ ( �✓�.>J� .a..� 2°�d�. SWIMMING POOL RECEPTOR d .. CITY r!r,m'd.,.,�''„�,.�,.,�,,t TEL,NO.`�,6:�-�-��L�% LA\N'N SPRINKLER SYSTEM, STATE J.-7�-�j� ? L C. WATER riEATER �—.� !ICEhSc NO./ �� CLAS� , GASSYS'EM `.��"'��OUTLETS �.� ��,� AFPROVALS DAT[ �i PG ort's.,�,),G.�"iup�..� � OUTLE'SOV�R UNDERSLAB WORK .�.� '"`�^'� �' ,w .�� 5 P[RSYS7EM _�, ROUC:�H FLJf�131NG �� : � �g� �^�"�� GAS PIPING � � ..,�_.�.._ � � GAS VEN� � � "�—' HOT W�ATER I-+EATER� � PL�U�IIBING FI;CTURES� � - �„ GAS TEST f95 � Plan check fee uri�TYco.r�oTi�ieo � PLUMBING PERMIT ISSUING FEE$ �S �I�IAI �,_.... F..-�� .-Ft:��... i'..�: TOTAL FEE �`� � _._, Plan check appll�ant PLAN CHECK VAI.IDAiION Name � Address City Tel.No. I HER[6'/ACKNOWLEI]GE THAT I NAVE REAU THIS AFPLIC�fIQN AND STA`F. "'" �� ' � '�' 7HAT 7NE 0.BOVE IS CORRECT AND AGREE l0 COMPLY WIIH AlL COU�VTY ORDI�lANCES - � ANDSfRTELAWSREGIJ'_AIINGPLUMBING.� � PERMITVALIDATIOI�I t��g � �?'�� `� +,� � � I HFREBV CEHTIFV TH47 I AM PROPFRLV qFGISTEREIJ AND!OR LICFNS%.D AS 5. � . . $' 't '� FEQJIREO BY LOS ANGFl.ES C.Ol1NTV AN�STATE OF CALIFORN'..A DR 7HAT I AiN THF ,. , , , , 7� � A" .. +J,�'�l..r'Li' �� ' . LEGAL OWNER OF,ANO IN7EN�TO RESIDE IN iHE ARUVE Df:SCR18ED RES!CENT:AL FROPERTY. � / . „ pg ;�.,'`,� ft . . . S�GNATURE CrP ,G,A^„A^a - Y� . . . OFP'eR1/iiTTEE ��'�•r� s ;,R .�� fy�. .-. w.. .... . � DISTRICT NO. PRO�CESSED BY �- `�-�,�?-��✓�' INDUSTRIAL �� - �- � � � � `+VASTE APPROVAL