HomeMy Public PortalAbout9243 GARIBALDI AVE_Plumbing__ 7a^WA ic■•170). 11/7d 11
T APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLKII►Jf TO HLL IN(PRINT OR TYPE) AADD sSoel 1'l L1/h�/�/
NUMBER HXTURE OR ITEM O FEE
WAT-ER CLOSET LOCALITY
NEAREST
BATH IUB CROZS7.
SHOWER OWNER
LAVATORY LMAIL
ADDRESS
SINK CITY % j . TEL.NO. .
DISH W ASH ER OONTRACTQR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
STY TEL NO.��JS
LAWN SPRINKLER SYSTEM
WATER HEATER U ACENSE NO. CLASS 3
/. GAS SYSTEM OUTLETSG P BY
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WASE AP(sROVAL V
I ION RECORi} in
Plan check fee
PLUMBING PERMIT ISSUING FEt$
TOTAL FEE
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APPROVALS DATE D6ngr6R'9 SIGNATURE
Name UNDER SLAB WORK
Address F ROUGH PLUMBING
qty Tel.No. GAS PIPING
I HERESY AC"OWLEDGE THAT I HAVE RLAD THIS APPUCAb6N AND STATE GAS VENT
THAT THE ABOYE IS CORRECT AND AGREE TO COMPLY WfTH ALLGOII NTY ORDINANCES � � ,�
AND STATE LAWS.RUIG EGULATPLUYOING. HOT WATER HEAT$t
I HDIYeY CUTIFY THAT I AN PRO"RLY REQI:STMED AND/OR LICE?LSdD AS PLUMING FIXTURES
REQIJPt D BY LOS ANGELLS COUNTY AND STATE OF C'ALIPORNIA OR THAT I Am TFM GAS TEST
LEGAL OWNER OF,MID IWMMb-TO RES)DE IN TF4 ADOVE DESCRIp ED MiiSIDENTML
PSOPERTY. LMUTY CO.NOT IF]ED
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O PERM fl'-fC Fl NAL. �
PLAN CHECK VA IDATION CTL YO. CASH PERMIT VALIDATION oLa CASH
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APPLICATION FO LU M B LN PERMIT
\COUNTY OF LOS ANGELES BUILDING AND SAFETY
FORAPPLICANT OFILLINUpRINTORTYPE) BUILDING
NUMBER FIXTURE REM O FEt A�RE55 �' D
WATER CLOSET - LOCALITY
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N EA REST
BATH TUB CROSS ST
SHOWER OWNER
MAIL
LAVATORY ADDRESS y A-&,
SINK cv TEL NO.
DISHWASHER CONTRACTOR Nor-7vf3
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
WN SMQTY TEL NO.
k � N � �EM STATE LIC
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS r.Y APPROVALS DATE INSAECTOR' SIGNATURE
EI�R UNDER WORK
go"PLUMBING
'GAS PIPING
GAS VENT w
HOT WATER HEATER
PLUMBING FIXTURES
GAS TE57
Plan check fee UTILITY CO.NOTIFIED
PLUMBING PEkMIT ISSUING FEE;
TOTAL FEE HNAL r�O •?� �`
Plan Check opplkbnt PLAN CHECK VALIDATION
Name
Addrm
city Tel.No.
I HEREITY ACI(NOWLCDGI THAT I HAVE MAD THIS APPLICATION ARD STATE
THAT THC ABOVE LS CORRECT AND AORU TO COMPLY WITH ALL COUNTY ORDP ANCES
Aro STATE LAM REGULATING PLUMBING.. PERMIT VALIDATION :90 Q'6 2 A
I FIEALSY CCR71!*1'THAT I Ail PROP kItLY REGISTER CD AND/QR LN;QNSED AS
REOUIR CD BY LOS ANGELES COUNTY ANDS ATE OF CAUPORNW OR THAT I AN THE # O O O O O 5
LEGAL OWNaR OF.ARD INTEND TO RESIDE IN THE Agave DE9CRIOED RESIDUCnAL 1300 PROPERTY. Z O O .A O O
SIO NATURE / O O O 1 �. O O 6S
C, P E Rld fTTE E
DI NO. P B 0925-78
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I N DUST RIAL
WASTE APPROVAL
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APPLICATION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
I WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEARCROSCROSEST C l-
NUMBER FIXTURE OR ITEM �j/ OWNER
WATER CLOSET �L j
BATH TUB ADDRESS L /
CITY TEL. NO.
SHOWER
CONTRACTO yyr
LAVATORY '() r
!
SINS ADDRESS
!�
DISHWASHER CITY I
TEL. NO
CO 8'S A ❑
LAUNDRY TUB REGIST8A80N NO. COIINTY ❑
CLOTHES WASHER DISTRICT O. 6R ZO E PRS BY
WATER HEATER � I �; P�
Ia
GAS SYSTEM INDUSTRIAL o
WASTE APPROVAL V
INSPECTION RECORD
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V
W
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0 $1.00 PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
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TOTAL ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE GAS TEST
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE / �:�
OF PERMITTE
FINAL
VALIDATIOROBERT A. WOOD
CK. M.0. CABH SUPERVISING MECHANICAL ENG'R