Loading...
HomeMy Public PortalAbout5411 GOLDEN WEST AVE_Plumbing__ I 76A667A CE 817(REV.6/781 ©s APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM @ FEE ADDRESS 54,11 Golden Wo. st, WATER CLOSET LOCALITY Temple " t NEAREST BATHTUB CROSS ST, SHOWER OWNER .-+0 >r'bgVetj eV. Corp. LAVATORY MAIL ADDRESS SINK CITY TEL.NO. DISHWASHER CONTRACTOR s T Yy CLOTHES WASHER ADDRESS c: SWIMMING POOL RECEPTOR --- '"--- AWN SPRINKLER SYSTEM CITY TEL.NO.59 q LIC. !! WATER HEATER LICENSE NO. y`, CLASS . GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING 0 GAS PIPING V W GAS VENT LL HOT WATER HEATER ,. OC PLUMBING FIXTURES GAS TEST 0 Plan check feea. UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL VJ Plan check applicant PLAN CHECK VALIDA ON Name Address City Tel.No. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES I AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION . 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 LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERM ITTEE q. 111' ♦ DISTRICT NO. PROCESSED BY 7 i INDUSTRIAL WASTE APPROVAL