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Home My WebLink About1692 (17) �anaaxn }� CE 817(REV.11/78) LL APPLICATIQN �OR PL.UMBtNG PERNfIT COl1N�Y Of tOS ANGELES BUILDING ANQ SAFETY . �__ 33/-df : . FpR APPLlGAN7 TQ PJIL tA1 JARiNi OR 3yPEi ' BUIiDING , � AQDR€SS ....... �.�_.�_. .. . NUMBER �tXTttREORt�EM . 1� . FEE WATER ClOSET � �OCAtiTY NEAREST . BATH iU8 Q"� CROSS 5T. SHOWER ,�.�{ �WNER �j ,. ■' u Cl/�`-'C_/ IAVATORY �1 �� ' ,�� / (/ � ADDRE55 p� � ��v.— S1NK 4"� CITY TE�N . ��D I DlSHWaSHER x-�� _p /a . 11 p y CONTRACTOR ��JLQ �J � CLOTHES WASHER � ADDRESS .�3�� SWIMMING POpL RECEPTOR CITY TEL.NO. �1—�LS(p� LAWN SPRiNKLER SYSTEM STATc /�f�j Llf. WATER HEATER � LICENSE NO. / / /� CLAS$ �� GAS SYSTEM �OUTLETS � APP�OYALS DAT INSP UF'S StGNATURE � OUTLETSOVER UVDERSLA&W'ORK ,r �. 5 PER SYSTEM ROUGH PLU,tiABtNG � GAS PVPiNG (31 V GA$YENT � HOT WATER HEAiER � PiUPJ�n�N'v'FIXTUReS T� � GAS TEST � � Pian check fee UTILITYCO.NOTIFIED - � _... _._. ---- PLUMBING PERMIT ISSUING FEE�-----._.._.�...—_.. —�..------- -------�----- —_.------ ._ _. _._...._ - - ; "_..__._.__...._._....._._'__""___'_ . R TOTAL FEE � FINAI � Plan check applicont PIAN CHECK VALIDATION Nome Address ... /i - 0 9�-79 � City Tel.No. � _... ........_ . __....__._... _.. . .. � ,_ ._ _ ��p'/2 I HEREBV ACNNOWLEDGF TNAT I HAVE READ THIS APPIICAiION AND STATE THAT THE ABOVE IS CORREC?AND AGREE TO COMPLV WIiH AL�COUNTY ORDINANCES ` _ , .. allo srnte.u+ws.eEcuu�z�race�u�sua6:... _ _. PERMfT VALiDATION � . , .S— . l.F.1EREBY LERT4FY IIMi 1 AM�PROPERLY REGISTFRED RND/OR tICENSED AS �� REOUIRED BY LOS ANGELES COUNTY AND.STATE Of..CALIf.ORN1A OR.THAT..I.AM�TME� �� / ��t�n� ��'LEGAL OWNEH OF,AND INTEND TO RESI�E 1N TNE ABOYE DESCRIBED RESIDENTIAI. � � ! �U PROPERTY. � SIGNATURE /- ' � `�� OFPENMITTEE - �- . � � � � �� DISTRICT NO. R CESSED BY v1' INOUSTRIAL WASTE APVROVAL ii�