HomeMy Public PortalAbout5601 A & B WELLAND AVE_Plumbing__ 76A667A.
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS u ��✓ GL-��� (,(�Lt¢�
LOCALITY �C/ e 7)00
WATER CLOSET
NEAREST p
®�.. BATH TUB CROSS ST. Vic ®19A,
SHOWER OWNER olezoq ..
LAVATORY MAIL
ADDRESS f� G1�/i �` MM .
�. SINK )CITY,4 t j v/� TEL.NO.
DISHWASHER CONTRACTOR ytoij
CLOTHES WASHER ADDRESS`?QOMAA ( ' �If
SWIMMING POOL,RECEPTOR
CITY 410VIAIM* TEL NO.
y LAWN SPRINKLER SYSTEM STATE LIC. .
�3s WATER HEATER LICENSE NO. ' CLASS ^3/0
�. GAS SYSTEM OUTLETS VGAS
OVALS DATE, INS.ES. R'S SIGNATURE
OUTLETS OVER WORK'. // 7
5 PER SYSTEM. MBING 7
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
Plan Check fee' UTILITY CO.NOT!FtED
PLUMBING PERMIT ISSUING PEE$ A
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATION !�
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Address D- '77&,0 ,1v7-
City
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City Tel.No. 7�sT a/�1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE '
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY.ORDINANCES
AND STATE LAWS REGULATING PLUMBING: PERMIT VALIDATION ;2 5 3&0 A
I HEREBY CERTIFY THAT I AM PROPERLYREGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE #'o O O O O 5
LEGAL-OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY, '
L - 2 D o97,00
SIGNATURE „••,C�?We�i�� n
OF PERMITTEE 0 0 0 9 7 0 0 5
DISTR .N� PR SSED BY 0 7 09-79
INDUSTRIAL
WASTE APPROVAL