HomeMy Public PortalAbout9672 OLIVE ST_Plumbing__ 76A667C (CE-91�713) -9/79 • '% `�' �
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APPLICATION FOR PLUMBING PERMIT {�
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET LOCALITY C� L
NEAREST hg erg
BATH TUB CROSS ST.
v SHOWER OWNER d ilolp S -errJ
LAVATORY MAIL
ADDRESS / C/
SINK CITY ��� TEL.JPO. rpr�jd
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOCRECEPTOR
CITY TEL. NO.
LAWN SPRINKLER SYSTEM
STATE. LIC ,
WATER HEATER LICENSE NO. CLASS
d
DISTRICT NO. GROUP
GAS SYSTEM OUTLETS A/ IZONE OCE S D BY � �
OUTLETS OVER t? CJ Z
5 PER SYSTEM s�
INDUSTRIAL
C7
WASTE APPROVAL yJ
�y �--'' INSPECTION RECORD �
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR-S SIGNATURE
UNDER SLAB WORK
.ter
Address ROUGH PLUMBING 22 -9-27
' c
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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
LICENSEDAS 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 DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATU REY `
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDA .ION cK. M.O. cnsH
1 s��AN z5 .5 0 �. �.5 0 a��