HomeMy Public PortalAbout4944 HALLOWELL AVE_Plumbing__ 76A667A
CE 617(REV.6/78)
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING ANDSAFETY
FOR APPLICANT TO FILL IN(PRINT bR'TYPE), BUILDING
ADDRESS Tj'ect &13645 Lot
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY T 1 C• t
NEAREST
BATH TUB00
CROSSST bower Azusa + Tialifax
SHOWER OWNER FairhaVen DeV. Co .
LAVATORY �j :0:0:1 MAIL
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER -____3_ 00ADDRESS 800 Pglomares
SWIMMING POOL RECEPTOR
CITY -V me TEL NO 0828
LAWN SPRINKLER SYSTEM
' LisJATE LIC
WATER HEATER
00 ICENSE NO 31-5421 CLASS B C 36
GAS SYSTEM OUTLETS APPROVALS DATE 7 INSPES,OR•S SIGNATURE
OUTLETS OVER UNDER SLAB WORK Vhj;n'Z%Z�y91 116;vP-1—
5 PER SYSTEM ROUGH PLUMBING a1
GAS PIPING
GAS VENT
@3
HOT WATER HEATER r
PLUMBING FIXTURES
GAS'TEST• ® O
Pion check fee UTILIT,YCO NOTIFIED g
PLUMBING PERMIT ISSUING FEE$
TOTAL FEEQO FINAL ,
Plan check applicant PLAN CHECK VALIDATION
: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 ;92839A
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS #'O O O O o 5
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 I 2'o o37-.0 0
PROPERTY
SIGNATURE •O O O 3 7.O 0 U
OF PERMITTEE '
0221 =79
DISTRICT NO PROCE ED BY •
INDUSTRIAL
WASTE APPROVAL