HomeMy Public PortalAbout5932 IVAR AVE_Plumbing__ 76A667A
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• A11 PLOCAT�ON R Il -. LUIIV11 ' �.�G. PERM HT
COUNTY OF LOS ANGELES BUILDING ARID SAFETY.
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
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NUMBER FIXTURE OR ITEM @ FEE
ADDRESS
WATER CLOSET LOCALITY L
NEAREST
BATH TUB CROSS ST.
SHOWER :OWNER
LAVATORY. MAIL .
ADDRESS
SINK CITY—/—p cd TEL,NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM am
STATE v LIC.
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS APPROVALS DATE 'INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING '
GAS PIPING
GAS VENT
HOT WATER HEATER_ 0
D—
PLUMBING FIXTURE
GAS TEST //4
Plan check fee- UTILITY CO.`f0fIFIED 5'
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE G FINAL. i
r. Plan check applicant v PLAN CHECK VALIDATION
Name
Address a
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 - ""pp �7
'AND STATE LAWS REGULATING PLUMBING.' y PERMIT VALIDATION :C i 1 1. / A
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 O O O O o'5
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. 2.0 0r1,Q O 0
SIGNATURE O O O 1)a O l0
OF PERMITTEE
DISTRICTNO. RROCESSE BY 1 t03-78
INDUSTRIAL
WASTE APPROVAL