HomeMy Public PortalAbout5813 MYDA AVE_Plumbing__ v '
76A667A(C S I -11/76
APPLICATION FOR PLUMBING PERMIT
63y6 ��
BUILDING AND SAFETYDIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING /�„ n /� I
NUMBER FIXTURE OR ITEM ® FEE ADDRESS f/ 1✓A u
WATER CLOSET LOCALITY 0 \
NEAREST
BATH TUB CROSS ST.
SHOWER OWN
LAVATORY MAIL
ADDRESS 1 E
SINK CITY p p ®TEFL..NO.
DISHWASHER CO T IC INSTALLERS
CLOTHES WASHER ADLt920 E. GRAND AVE.
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CITPLE L�F�NO. _q 0
STATE LIC. ` —
WATER HEATER 00 LICENSE NO. CLASS
GAS SYSTEM OUTLETS DISTRICT NO. GROUP I ZONE rr PR SSED BY
OPER TS OVER
INDUSTRIAL
WASTE APPROVAL 0
INSPECTION RECORD 9
b
Plan check fee
PLUMBING PERMIT ISSUING FEE$ 1 4190
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OFPERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION (CK.,,.-)NLO. CASH
VEADV DV FOR RMU RNSIJ EMOO Wd as