HomeMy Public PortalAbout9036 ACASO DR_Plumbing_11/13/1978_water heater M
CE 8171REV 6/78)
_APPLICATION FOR PLUMBING PERMIT
" COUNTY OF LOS ANGELES BUILDING AND SAFETY '
FOR APPLICANT TO FILL IN(PRINT OR TYPE) g` BUILDING
ADDRESS '
NUMBER FIXTURE OR ITEM ' (91 FEE + y n
LOCALITY
WATER CLOSET
" NEAREST, w
BATHTUB CROSS
SHOWER 'OWNER �! f
LAVATORY MAIL -
ADDRES
SINKCITY TEL NO ,
T DISHWASHER
O
CLOTHES WASHER 1= . GRAND •
SWIMMING POOL RECEPTOR
14awtZa jCALIF-IfEL
70,
LAWN SPRINKLER SYSTEM' _ STATELIC
WATER HEATER _ " LICENSE N z CLASS
GAS SYSTEM OUTLETS . APPROVALS DATE INSPECTOR S SIGNATURE �?
OUTLETS OVER UNDER SLAB WORK I
5 PER SYSTEM ROUGH PLUMBING
' 'GAS PIPING ' + Q
GAS VENT
HOT WATER HEATER o
` 'PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITYCO NOTIFIED _z
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL, z 272.71/M01PA/cS(/@ zit
Plan check applicant �PLAN CHECK VALIDATION
Name # A14 .2'�•"� l4s1+�� 1 e611 A
Address `
1600
Tel No 2 • •
City '
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE ' 8 . • 1 a O O V
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ' + Z �/
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION ''t ' 1. 1 3— 8
/
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS C7
REOU IRED BY LOS ANGELES C TY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF AND IN D T RESIDE E ABOVE DESCRIBED RESIDENTIAL + -
.PROPERTY ,
+ Y ,
SIGNATURE
'OF PERMITT
DISTRICT NOp PROCE SED BY 1
INDUSTRIAL
WASTE APPROVAL /I