HomeMy Public PortalAbout9135 PRIMROSE AVE_Plumbing__ 7GAGG7C'V.E-V7E1) -9/79
` APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING /� . /` n`��yb (�f n 1 D�a
NUMBER FIXTURE OR ITEM @ FEE ADDRESS r, AlY rI lC /7 h
WATER CLOSET
LOCALITY ��M pk E L(*T
BATH TUB NEAREST ` d
CROSS ST'. /� `'/ p
/ SHOWER _3 00 OWNER NRVIT/ 7
S /s;-rA A
1 LAVATORY MAIL ADDRESS S
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR!3 EN �,� ��1 P�M G.
CLOTHES WASHER 1300 ADDRESS
SWIMMING POOL RECEPTOR � l _ f L L K—r
�
CITY QA(RQU�� TEL. N0.,3
LAWN SPRINKLER SYSTEM ^�
WATER HEATER QO LICENSE NO. ! %'a(0(0 CLASS..
CD
GAS SYSTEM OUTLETS Q/1 DISJTR�11CT NO. I GRA IZON P CES D BY O
OUTLETS OVERI-
5 PER SYSTEM INDUSTRIAL d
WASTE APPROVAL y
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $ Q
TOTAL FEE
Plan check applicant a a a S /--/k T Ul2Y—"�
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
Cit Tel. No.
Y GAS PIPING 'veyl-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. -
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS 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 DESCRIBE RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED _
SIGNATURE '
OF PERMIT TEE � FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI N cK. M.O. CASH
3 .9 3f--JAN 31 5 D 2 2.5 0 A-�o