HomeMy Public PortalAbout10554 DANBURY ST_Plumbing_11/17/1977_pool & outlets 76A667AIC¢81781- 11/76
APPLICATION FOR PLUMBING PERMIT
BUILDING D SAFETY DIVIS5IOW
FOR APPLICANT TO FILL IN(PRINT OR TYPE] BUILDING c /D f�
NUMBER FIXTURE OR ITEM @ FEE ADDRESS -L.l
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST. MA
.I,
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY e e TEL NO �^
DISHWASHER CONTRACTOR -
CLOTHES WASHER Q
I ADDRESS �N' a
SWIMMING POOL RECEPTOR
� YM 6a"63
CITY TEL.NO.-
LAWN SPRINKLER SYSTEM STATE [y[yt����
WATER HEATER LICENSE NQ V5107L- CLASS
GAS SYSTEM OUTLETS DISTRIC7 N�� G PN' CESSED
OUTLETS OVER ll,'rJk y
5 PER SYSTEM INDUSTRIAL 6
WASTE APPROVAL Ov
INSPECTION RECORD 139
O
F�
V
W
C16
N
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE$ v
TOTAL FEE U
Plan check applicant -
APPROVALS DATE INSPECTOR5 SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING p
City Tel.No. VGASTEST ---?O-;fr
PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR LICENSED ASFIXTURES/� yy�REOWREO BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA ORTHAT I AM THE �O-;f LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIALPROPERTY. NOTIFIEDSIGNATUREOEPERMITTEE
PLAN CHECK IDATION ^r'.- ^cK^,-•M.ov�""`cAs)47 PERMIT VALIDATIONcK. M.O. CASH
-- --- -- -- --- - -� --n 1 9, 7 -rNOV 17 5 1) U.50 a �
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