HomeMy Public PortalAbout6263 AVON AVE_Plumbing_6/6/1979_gas system outlets 76AS67A)
CE 817(REV 6/78)
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APPLICATION F R PLUM NG PERMIT
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COUNTY OF LOS ANGELES BUILDING AND SAFET
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FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS Ze
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY
N EAR EST /
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAILADDRESS 2 h�
SINK CITY �+ �V t TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR F
CITY TEL NO
LAWN SPRINKLER SYSTEM STATEJ LIC 'J
WATER HEATER LICENSE NO 5/ CLASS 2 v
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTORS SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING 6
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES ?
GAS TEST LZ 1610r —& /Z Q MX-vo—
Plan check fee + UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
FINAL -5m
Plan check applicant PLAN CHECK VALIDATION
Name
Address
City Tel No /, �]Q
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE �41! a 5 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION # O O 0 O O 5
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 2 O O 1,000
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY
SIGNATURE
OF PERMITTEE 06061-79
DISTRICT NO OCESSED BY
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INDUSTRIAL
WASTE APPROVAL
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