HomeMy Public PortalAbout9601-9603 LONGDEN AVE_Plumbing__ 76a667A hCe 8(7e) -a/» ' I�
APPLICATION FOR PLUMBING PERMIT
BUIING,AND SAFETY DI LO
ta
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM e • •FEE ADDRESS 9601 angdon Ave. o3
WATER CLOSET LOCALITY Temple Ci1'fy
� NEAREST '
BATH TUB CROSS ST.
SHOWER D�. OWNER FBjir Devel o sent,
LAVATORY �QMAIL
ADDRESS 8656 T. Huntington Drive
SINK CITY a TEL.NO.
DISHWASHER {/`D ()wen BMS. Plumb
CONTRACTOR ince
CLOTHES WASHER h 6 ADDRESS f_.�� No Baldwin Ave,
SWIMMING POOL RECEPTOR
CITY X. Monte TEL.NO. 4 3-CO78
LAWN SPRINKLER SYSTEM
STATE 1WATER HEATER LICENSE NO. 23�-. / CLASS C3
GAS SYSTEM OUTLETS ` DISTR"NO. 1 4619UP NE P ESS BY
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OUTLETS OVER �' d
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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/- _
Plan check fee
PLUMBING PERMIT ISSUING FEE$ D
TOTALFEE
Plan check applicant
APPROVALS PATk PATIPW NATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING zz
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST —ZG -r- /Z- r
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL -
PROPERTY. UTILITYCO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
BIB
P".CHF6VALI6AT'5Nr-0k4P1VrMSjkTf PERMIT VALIDATION cK. M.Q. CASH
POLICY HOLDERZ&
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POLICY NUMBER: Yeo /67-3-3--S-72-- rD ,���
76A667A �Qi'�'�"
CE 817(REV.6/781
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 97,
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NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST. t,
VYIdge Awe-
SHOWER OWNER F ke U n7e
LAVATORY MAIL
ADDRESS
SINK CITY Ofin QA TEL.NO.
DISHWASHER CONTRACTOR
rr+os o S g
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR ,
CITY TEL.NO.9
LAWN SPRINKLER SYSTEM STATE LIG.
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
PLUMBING FIXTURES 9
GAS TEST N
Plan check fee UTILITY CO.NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL 0Av
Pla heck pplicant PLAN CHECK VALID {ON
Name
Addfess 9 V
f.(ty Tel.No.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE 0 1 8 3.9 A
THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION # O O O O o 5
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE I 2 O o 1 a Q D
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 1
PROPERTY. 0 0 0 1 O.CGI1
SIGNATURE cit.1� , 1215-78
OF PERMITTEE
DISTRICT NO. PR SSED BY
I`5- 0 8
INDUSTRIAL
WASTE APPROVAL