HomeMy Public PortalAbout5432 GOLDEN WEST AVE_Plumbing__ Y_E 817(REV 11/-78)
APPLICATIO OR PL 1 G PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRES
SWIMMING POOL RECEPTOR
CI
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
OUTLETS OVER
5 PER SYSTEM ROUGH PLUMBING
' GAS PIPING �ir� //Z 79 /L/� V
GAS VENT 29
HOT WATER HEATER
PLUMBING FIXTURESvv
GAS TESTS 9 �Z
Plan check fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check apple nt PLAN CHECK VALIDATION VTT
Name
Address
City Tel No 27 7 2 5 A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION # O o 0 o o5
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS rY O O 1 ( O O
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE L U
LEGAL OWN F AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL lo
O O 0 0 U
PROP Y
L5�1GINATIL1.5f== 1. 13-79
F PERMITTEE
DISTRICT NQ.Y i,/ OCESSED BY
J,
INDUSTRIAL Gil/
WASTE APPROVAL
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CE 81
CE 71RE V.6/781
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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 5432Goldens t
WATER CLOSET LOCALITY Z eQ 1Q. c t
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER ? 9 w;'heveu iA V. Corp«
LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO,
DISHWASHER CONTRACTOR florsoy Plumbing p C q«
CLOTHES WASHER Vp�y
ADDRESS S? 0 zuelom®res
SWIMMING POOL RECEPTOR
CITY TEL.NO. _
LAWN SPRINKLER SYSTEM STATE 7 LIG
WATER HEATER LICENSE NO- 315421 CLASS •�' ) ,
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK d
5 PER SYSTEM ROUGH PLUMBING O
GAS PIPING U
W
GAS VENT
LL
HOT WATER HEATER �.
CL
PLUMBING FIXTURES Q
GAS TEST O
Plan check fee UTILITY CO.NOTIFIED a
X
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDA ION
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
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION r
1 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.
w •a W
SIGNATURE
OF PERMITTEE
DISTRICT NO. PROCESSED BY
INDUSTRIAL
WASTE APPROVAL