HomeMy Public PortalAbout5134 SULTANA AVE_Plumbing__ • TBABBJC ICE 817 A) 1"0 �
APPLICATIO ORPL ,SING PERMIT
COUNTY LOS ANGELES
DEPARTME COUNTY EN ER
BUILDING AND SAFETY DIV ION
FOR APPLICANT TO FILL IN PRINT ORTYPEI BUILDING C ,p
NUMBER FIXTURE OR ITEM ® FEE ADDRESS YJ
WATERCLOSET LOCALITY r ' P>� / ti
NEAREST
BATHTUB CROSS ST OL Ol
SHOWER OWNER -PIM
, ,Q .p
LAVATORY ADDAILRESS q /•G{ 'J
SINK CITY 'r rd-3 Z' ` ) �' TEL NO
DISHWASHER CONTRACTOR t
T r
CLOTHES WASHER ADDRESS LS� P
SWIMMING POOL RECEPTOR c ( /
LAWN SPRINKLER SYSTEM CITY L4-(_,e) `.. TEL NO �� rJ\21 3a/.
STATE LIC
G I Z CLASS
WATER HEATER LICENSE NO
/ CAAST SYSTEEME OUTLETS DISTRI .NOO� Y-4
fP PNE ESS Y y
5OPERSPS& R a� i►
INDUSTRIAL
WASTE APPROVAL Q
INSPECTION RECORD V
a
O
Plan check fee
PLUMBING PERMIT ISSUING FEE E
TOTAL FEE ,
Plan check applicant
Name
APPROVALS DATE INSPECTOR SSIGMATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel Na GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER
AND STATE TAWS REGULATING PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AN THE GAS TEST
LEGAL OWNER OF AND INTEND TO RESIDE IN THEA ESCRIBED RESIDENTIAL
PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE FINAL
vi
PLAN CHECK VALIDATION CK AID GSH PERMIT VALIDATION cK M O CASH
9 8 .1 APR 11 6 0 9.0 0
®s
i
7SA66.-CHA)I7 1-64
APPLICATION FOR PLUMBING PERM T ,
COUNTY OF LOS ANGELES
DEPARTMENT OF COMM ENGINEER
p�Ip ]� 7ADDR=
B1 IIAG AM I OUNTY €NUINCRON
WILLIAM A JENSEN SUPT Or BUILDING
FOR APPLICANT TO FILL IN
NUMBER FIXTURE OR ITEM EACH FE NCR t
WATER CLOSET 81 25 e�
DATE TUD 115
BHOWER 116 CTT TEL x0
1 LAVATORYITS CONTRACTOR
BDa 115 ADDRffiR 1
DIBNWASHEB 115 CDT TEL NO 4eo,,?
LAUNDRY TDB 175 CONTRACTORS STATE
REGISTRATION NO COUNTY
CLOTHES WARM 175 DItT/RIC7 N GROUP N[ P [IMe[D By
WATER HEATER I50 SO .�j �1
OAS SYSTEMS OUTLETS i a WASE L APPROVAL 6
OUTLETS OVER S PER SYSTEM 50 INSPECTION RECORD O
ISE
a
N
Z
J�A�
YAPPROVALS DATE IN[P oR[SIONATUR[
PERMIT S00' UNDER SLAB WORKROUGH PLUMBINGTOTAL FEE S GAS PIPINGACNNOWLKOG[ THAT 1 NAV[ MAP THTION GA6 VENT
ANO [TAR THAT TN[ ADOV[ 1[ CORRQCT ANO AORPLYWRHALL COUNTY ORDINANC[l AND [TAT[ LAWTING HOT WATER HEATERPLUM[INO
1 HE"My CERTIFY THAT 1 AM PROPERLY REGIS /OR PLUMBING FIXTURES
uc[N[m A[ REQUIRED FY LOS ANO[L[[ COUNTY Or GAS TEST w /� —LCALIFORNIA OR T T I AM THE "GAL OWNER OF TOREIn[ IN TH[ E[D wID[NTIAL PECPKUTILITY CO TIFIED
CIGNATUR!
OF PERMITTEE FINAL
/V7FLIDATTON ROBERT A WOOD
( cK / M o GSH SUPERVISING MECHANICAL ENG R
1A�o5 A A 4—� SEP 10 5 D 8.75- r