HomeMy Public PortalAbout9015 ACASO DR_Plumbing_12/12/1979_water heater, shower, lavatory *iA
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CE V 11/78) .
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�"-�,APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY •
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING G
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
If IS
/ WATER CLOSET LOCALITY
NEAREST • '
BATH TUB CROSS ST
/ SHOWER OWNER
s MAIL I�
LAVATORY ADDRESS Q C ro
SINK CITY a TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS wAy
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS A DATE INSPECTOR S SIGNATURE
OUTLETS OVER WBItIR ftAB WORK
15 PER SYSTEM ROUGH PLUMBING f 9 Q d
GAS PIPING V
GAS VENT Qt
HOT WATER HEATER 0
PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITY CO NOTIFIED z
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATION20�7�/CwH�-
4 MR 7—ca t` m 1 C- /<
Name
Address
City Tel No 9 81 9,6 R
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 o5
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION `
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 12 O O 1 600 L O O
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL *O O O 1 6 O O U
PROPERTY
SIGNATURE 40 A F1 2 1 2-79
OF PERMITTEE
DISTRICT NO P CESSED BY
INDUSTRIAL
WASTE APPROVAL