HomeMy Public PortalAbout5212 MCCLINTOCK AVE_Plumbing__ 7GA667A
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APPLICA 1 FOR pe ERMIT
COUNTY OF LOS ANGELES BUILDING AN SAFETY
11 -
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS
NUMBER FIXTURE OR ITEM ® FEE i
LOCALITY
WATER CLOSET
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO-541
DISHWASHER CONTRACTOR
CLOTHES WASHER ^
ADDRESS
SWIMMING POOL RECEPTOR
CITY , C. TEL.,NO.
LAWN SPRINKLER SYSTEM STATE 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 16
GAS VENT qj
29
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
ub
Plan Check fee UTILITY CO.NOTIFIED g
PLUMBING PERMIT ISSUING FEE$ o
TOTAL FEE D FINAL ����@ !-•a" ,�� 1
Plan check applicant PLAN CHECK VALIDATION �y
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
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION j ;[�]O !1
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS V G U fl
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 11 O O O O O 5
LEGAL OWNER OF.AND INTEND TO RE DESCRIBED RESIDENTIAL
PROPERTY. ..., 2 n o ' a O 0
TURE
OFPERMrrr E O O D 1 a 0 p
DISTRICT NO. ROCESS BY 0 3 1 6—7 9
INDUSTRIAL
WASTE APPROVAL