HomeMy Public PortalAbout5611 A & B SULTANA AVE_Plumbing__ 7l W7A
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINTOR TYPE) BUILDING , �� r
ADDRESS
NUMBER FIXTURE OR ITEM Y FEE ��
/ 0 LOCALITY
WATER CLOSET
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY VMAIL
'ADDRESS
SINK 0 "CITY TEL NO J
DISHWASHER tONTRACTOR
CLOTHES WASHER ADDRESS ZL
+ SWIMMING POOL RECEPTOR r
CITY TEL NO
LAWN SPRINKLER SYSTEM LiC /I
WATER HEATER SICENSE NO Of CLASS
GAS SYSTEM OUTLETS O APPROVALS DATE I Ec SSIGNATURE
O i ETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING 0
GAS VENT V
d
HOT WATER HEATER 0
PLUMBING FIXTURES / G
GAS TEST I�!
TAT
Plan check fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECVALID T 1�7
107
Name 1G0/LI($/Q 'Y �' "/ /y/ •'-
AddreSs
Clry Tel
I HEREBY ACKNOWLEDGE THAT I HAVE AM THIS APPLICATION AND STATE L Z ®Q 0 A
THAT THE ABOVE IS CMRECT AND AGREE TO COMPLY Win ALL COUNTY ORDINANCES As EC
AND STATE LAWSREGLMTING PLUMBING PERMIT VALIDATION It'• 0
I HEREBY CERTIFY"AT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED0 Q ^n
BY LDS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE /
LEGAL OWNER OF AND INTEND TO E IN THE ABOVE DIESCRIS RESIDENTIAL
PROPERT
SIGNATURE
CIP PERM nTE VIS
DISTRICT NO PROCESSED BY �3,p U Q9,
IN DL15TRIAL�
WASTE APPROVAL