HomeMy Public PortalAbout9915 GARIBALDI AVE_Plumbing__ 76A667 (CE-8171-8-71
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS /
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
OWNER
WATER CLOSET 1.75
MAIL
BATH TUB 1 75 ADDRESS L Q�
SHOWER 1 75 CITY TEL. NO.�„? �-
LAVATORY 1 75 CONTRACTOR
SINK 1.75 ADDRESS Q
DISHWASHER 1.75 CITY TEL. NO.yL� G)
CLOTHES WASHER 1 75 STATE LIC
SWIMMING POOL RECEPTOR 1 75 LICENSE NO. CLASS
DISS$ICCT N,Q,/ GRg1JP Z E E 8'Y
LAWN SPRINKLER SYSTEM 1 .75 l CJX
WATER HEATER 1 75 INDUSTRIAL f/ C.
WASTE APPROVAL G
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 Z , AJ,1, O
F..
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W
Vf
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Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE $ /3 00
TOTAL FEE `7
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THATI AM E LEGAL OWNER O AND INTEND TO 11
RESIDE IN THE ABOVE DE RI's ED ZENIA
TP PERTY. FINAL
SIGNATURE
OF PERMITTEE —
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH 9 i°itlK15
r 4.75-
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