HomeMy Public PortalAbout6273 AVON AVE_Plumbing_12/5/1977_ 76A667A ICF 6178) 4/77
Y APPLICATION FOR PLUMBING PERMIT
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BUILDI AND SAFETY DIVISION
FOR APPLICANT TO FILL IN IPRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS Z 7 O p E
CLOSET LOCALITY
WATER
NEAREST G
BATH TUB CROSS ST
SHOWER OWNER,/
LAVATORY MAIL
ADDRESS
SINK CITY (r TEL
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS i DISTRICT NO GROUP ZQNE ZCE4SSEBY
_ o OC , CD
OUTLETS OVER 6 "
5 PER SYSTEM INDUSTRIAL V
WASTE APPROVAL wo
INSPECTION RECORD v
Plan check fee }
PLUMBING PERMIT ISSUING FEE$
TOTALFEE
PIan'bkeck applicant
Name APPROVALS DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
Address I ROUGH PLUMBING
City Tel No ! GAS PIPING s
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES i HOT WATER HEATER
AND STATE LAWS REGULATING PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REG ED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY ANDS OF CALIF NIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF A K VE ESCRIBED RESIDENTIAL '
PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PER MI ( FINAL
PLAN CHECK VALIDATION CK M Q CASH PERMIT VALIDATION cK M o CASH
4 6 2'L-DEC 5 5 ® 1 3.5 (D ,&
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