HomeMy Public PortalAbout4938 HALLOWELL AVE_Plumbing__ 76A667A "•
CE 8171 REV.6/78)
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS Tract #13645 Lot #d36 NUMBER FIXTURE OR ITEM @ FEE -
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2 WATER CLOSET' NEAREST
1 BATH TUB 00 CROSS ST r
SHOWER OWNER F irrt V II V
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LAVATORY '
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I SINK 0 CITY TEL NO
DISHWASHER CONTRACTOR
1 CLOTHES WASHER 00 ADDRESS
SWIMMING POOL RECEPTOR
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LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO - CLA55
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER 00 UNDER SLAB WORK -:7
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT Bd
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PLUMBING FIXTURES If
Y
GAS•TEST -2,1
Plan check fee = UTILITY CO'NOTIFIED
PLUMBING PERMIT ISSUING FEE$ 91 00
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TOTAL FEE FINAL
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PLAN CHECK VALIDATION
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE r ^
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 02H
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # Q O O b 05
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 2'O O 3 7 0 0
PROPERTY '
SIGNATURE r O 0 O 37005
OF PERMITTEE 0 ^�f 2 1 -79 079
DISTRICT NO. PRO ESSED BY
INDUSTRIAL
WASTE APPROVAL