HomeMy Public PortalAbout9923 NADINE ST_Plumbing__ CE 8 7
CE817
611 I7 REV.6/78) y �/
03
APPLICATION ,FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND.SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING E ,
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCAL(
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAIL"
ADDRESS
SINK CITY TEL.NO,
DISHWASHER C
CLOTHES WASHER
A
SWIMMING POOL RECEPTOR
clTEWLE CITY, MI RL.NVV _ Q T
LAWN SPRINKLER SYSTEM STATE. LIC.
WATER HEATER LICENSE N CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT V
HOT WATER HEATER C
PLUMBING FIXTURES
GAS TEST
Plan Chetk fee UTILITY CO.NOTIFIED _
PLUMBING PERMIT ISSUING FEE$j
TOTAL FEE FINAL `7
Plan check applicant I,�IPLAN CHECK VALIDATION �j fj� `�� <_
Name A14-'!6 m4& ��� /.�/ � I�W7�
Address
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE n
THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES •fi 1 6 1�Q A
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS Al 8 8 8 8 8 `C
REQUIRED BY LOS ANGELES COUNTY AND-STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. 2 8 8 ', A n A h
/0 0 V
SIGNATURE 8 O O
OF PERMITTEE
+ 04-78 4—7 8
DISTRICT NO. ESSED BY r
, . o g
INDUSTRIAL
WASTE APPROVAL