HomeMy Public PortalAbout5118 MCCLINTOCK AVE_Plumbing__ 7GA667C (CE-817B) -9/75
.M
{ APPLICATION FOR PLUMBING PERMIT {�
LJ.
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET
LOCALITY P�J
BATH TUB NEAREST
CROSS ST.
SHOWER OWNER X—dz p 2J
LAVATORY � MAI L cl ZJ ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL. NO.
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS DISTRICT NO. IGROUP ZONE RO SED BY
6 PER T SYSTEM R O6 v
INDUSTRIAL w
WASTE APPROVAL
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEES `0
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK i '%Z
Address
ROUGH PLUMBING �'�•'7
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICEN
SEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DES IBED RESIDENTIAL PROPERTYn UTILITY CO. NOTIFIED /
SIGNATURE.-fr !
OF PERMITT FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH
8 21tiAUG 23 5 B `/ - A98
1 3.� 0