HomeMy Public PortalAbout9841 BROADWAY_Plumbing__ 71 APPLICATION F PLUfViBIPERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT O FI LU N(PRINT OR TYPE( BUILDING
�'� '98441 E. Broadway
ADDRESS
NUMBER FIXTURE OR ITEM O FEE 'Tempie Ci
WATERaoSET LOCALITY P Y
NEAREST
BATHTUB CROSS ST.
SHOWER OWNER Edwin Gonzalez
LAVATORY MAIL
ADDRESS Same
j SINK CITY TEL.NO,287-3252
DISHWASHER 00 CONTRACTOR Universal Plumbing
CLOTHES WASHER ADDRESS 2631 Lee Ave.
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CITY So. El Monte Ca ULE1.NO
, 575-3460
STATE
LIC
WATER HEATER ELNSE NC ' CSS c36&20
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDERSLAB WORK
5 PER SYSTEM ROUGH PLUMBING 6
GAS PIPING
GAS VENT t at
HOT WATER HEATER 0
PLUMBING FIXTURES
6
GAS TEST ion�A. ZN
Plan check fee UTILITY CO.NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
FINAL 3
Plan check applicant PLAN C IDA
!I 3
Nomeell
Address
aiy Tel.Na. ;9 4 83.5 A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE M O O O O - 5
THATTHE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION 2 0 - 1 6 00
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 O O O 1 U O 0 U
LEGAL OWNER OF.AND INTEND TO SIOE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY,
0411 -80
SIGNATURE I
OFPERMITTE
TRICT/NO. PRO
SSEDEI
INDUSTRIAL
WASTE APPROVAL /'�