HomeMy Public PortalAbout5324 ZADELL AVE_Plumbing_9/28/1976_ 76AG67C(CE-8178) -9/75
APPLICATION FOR PLUMBING PERMIT
13UILDI G AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING �J
NUMBER FIXTURE OR ITEM @ FEE
ADDRESS 3a
WATER CLOSET LOCALITY m % l! .
BATH TUB NEAREST 1
CROSS ST. V ij ct It' '`M-
SHOWER OWNER 04�, r
ler
LAVATORY MAIL
ADDRESS j I
SINK CITY /e I(i TEL. NO.
DISHWASHER
CONTRACTOR n AQst P ,/f r
CLOTHES WASHER Y
ADDRESS gotj
LAWN SPRINKLER SYSTEM
SWIMMING POOL RECEPTOR
CITY r�� TEL. N =611
STATE "C
WATER HEATER LICENSE NO. g,7,;5 f CLASSCD
GAS SYSTEM 7�
DISTRICT NO. GROUP IZ�CNE P CESSED BY vTETS OVER / OUTLETS • 0, IT J' I 0
5 PER SYSTEM INDUSTRIAL w
WASTE APPROVAL y
INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. No. kGAS
PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONVENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGWATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ORBING FIXTURES
LICENSED AS REQUIRED BY L05 ANGELES COUNTY AND STATE OFTEST ��
CALIFORNIA OR THAT 1 A LEGAL OW R OF, AND INTEND TO l w�'
RESIDE IN THE ABOVE DE RIB D RESIDE A "PR RTY, UTILITY CO. NOTIFIED f J
SIGNATU
OFPERMITTEE �JL Sld�u
FINAL
V
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
3 9 5 n SEp 28 •5 D 7.5 0 ,&&d