HomeMy Public PortalAbout5419 SANTA ANITA AVE_Plumbing__ 7"7fA�
LE,,81 7(RE. .I1�/79)
APPLICATION FOR PLUMBING PER
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGj
[NUMBER FIXTURE OR ITEM ® FEE ADDRESS S �
WATER CLOSET LOCALITY -le
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NEAREST
BATH TUB CROSS ST.
SHOWER OWNER ^" j? VIM I�eA�a�
LAVATORY ADDRESS-r-�Z.4 vz /Q c f DU(/
SINK CITY. TEL.NO.
DISHWASHER 3 CONTRACTOR IV40
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR r
CITY O �v TEL.NO fp
LAWN SPRINKLER SYSTEM
or
STATE LIC. �7
WATER HEATER LICENSE NO.� • rJ CLASS 7 6
GAS SYSTEM OUTLETS APPROVALS DATE INSE R S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT dt
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST N
Plan check fee UTILITY CO.NOTIFIED g
A
PLUMBING PERMIT ISSUING FEE$ e7+ P
TOTAL FEE 3 FINAL 3
Plan check applicant PLAN CHECK VALIDATION
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Name rL-3✓? ���--r 790JT 5 9.5 A
O/✓�Y o7r, .I
Address # 0 0l0 0 0 5
City Tel.No. 2,.o -'37.00
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES O o O 3 7 O O U
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS I 1.0.5-79 1.O.5-7 9
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. 1
SIGNATURE I
OF PERMITTE
DISTRICT NO. OCEWD BY
D
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S
INDUSTRIAL
WASTE APPROVAL
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