HomeMy Public PortalAbout9040 ACASO DR_Plumbing_12/3/1979_fixtures 76A667A
CE 817(REV'1,1/78)
APPLICATION F R PLU IN PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING G►+-
D ` L/ L 5 /
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST. J f
SHOWER OWNER
/ LAVATORY MAIL
� ADDRESS
SINK CITYZA TEL.NO.
DISHWASHER CONT CTOR !
CLOTHES WASHER ADDRESS, '7 G
SWIMMING POOL RECEPTOR }
CITY A NO.
LAWN SPRINKLER SYSTEM
STATE //�� LIC.
WATER HEATER LICENSE NO. C% CLASS /
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK 6/71
5 PER SYSTEM ROUGH PLUMBING q
GAS PIPING
GAS VENT 6tg
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITY CO.NOTIHED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL '�{—�� Oe " e c--.,
Plan check applicant PLAN CHECK VALIDATION
Name
Address
City Tel.No. 0 6
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES # O O O O O
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION '
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 2 O 0 1 6,0 0
REQUIRED BY LOS ANGELS U Y AND STATE OF CALIFORNIA OR THAT I AM THE (
LEGAL OWNER OF.AND TE RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 'O O 0 1 6,0 0
PROPERTY. '
SIGNATURE
1203-79
OF PERM T -
6))1Z. JICT NNO. OCESS BY o
INDUSTRIAL
WASTE APPROVAL