HomeMy Public PortalAbout5116 A & B SERENO DR_Plumbing__ )6A669A
CKW;IRRV 6/.Ys) '
0.
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BIDING AND SAS
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM O E
RESS
A ✓
WATER CLOSET LOCALITY
✓ '�
NEAREST
BATH TUB CROSS ST cSY '07
_
SHOWER OWNER
C� LAVATORY n p ADDRESS a� DRESS
Z SINK D CITY TEL NO
Z D15HWASHER Q� CONTRACTOR
Edwp�d / eL
CLOTHES WASHEROki
ADDRESS p E�
SWIMMING POO(RECEPTOR 14 ``
CITY ({�jp 7iy>(./Q.- TEL NO -4&/-Z30
LAWN SPRINKLERSYSTEM
T LIC
WATER HEATER SCENSE NO 3 )C(-'4 kG CLASS If (0
Z GAS SYSTEM OUTLETS IRO
APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS( NJDER �7
5 PER SYSTEM UGH PLUMBING -
AS PIPING 0
AS VENT \ V
OT WATER HEATER F�
LUMBING FIXTURES U
Plan check fee TILITYCO NOTIFIEDPLUMBING PERMIT ISSUING FEE S
TOTAL FEE INAL ! L
Plan check applicant TPfL�AN CHECK VALIDA Ol.N AH WQS� y/lQ��]'�
Nome F v�`'r�`/ �SI /L,�j�Q'q 6YZG"E
Address3� 7 q (�'�I,-'LLQ a
Clry Tel No f
I HEREBY ACANOYLEWE THAT I HAVE READ THIS APPLICATION AND STATE y 2 A L 11
THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY ARTH ALL COUNTY ORDINANCES <V &6A
AND STATE UWS REGULATING PLUMBING PERMIT VALIDATION , «y
I HERESY CERTIPT THAT I AY PROPERLY REGISTERED AND/OR LICENSED ASREQUIED By ' rcrc 6 6 6,6 6
THE
LEGALBOWNERLOF AND URCNOS ANGELES D TO RESIDENTY DSNATHTTE E ABOVEP DESCRIBED RESIDECALJORptA OR THAT I NTUL L 6 - 6700
PROPERTY y
I
SGNATURE 6 6 6 6 7.0 0 6
IG
ATURE TEE
`(3423-79
DISTRICT NO PROCESSED BY ,
INDUSTRIAL '
WASTE APPROVAL