HomeMy Public PortalAbout5603 WELLAND AVE_Plumbing__ 76AG17A
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A.PPL.ICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS
NUMBER FIXTURE OR.ITE.M ® FEE
LOCALITY
WATER CLOSET
NEAREST
( BATH TUB CROSS ST.,04 G/✓� �f�tt
SHOWER OWNER V.,04,9&- CfO�s�`eJ�T'Ip�
d# LAVATORY ADDRESS V 7? PIMA /g vyW
SINK ITY /'�/� TEL.NO.-31
l,�*, /
DISHWASHER CONTRACTOR .Y, Al t6L
aJ CLOTHES WASHER ADDRESS �y
SWIMMING POOL RECEPTOR
CITY t�ey��� TEL.NO. IV71411 3 y'
LAWN SPRINKLER SYSTEM STATEga7/J��J LCI�
WATER HEATER LICENSE NO, a 5 7' C�
GAS SYSTEM OUTLETS APPROVALSTE INS T SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
09
HOTWATER HEATER
PLUMBING FIXTURES. 9
GAS TEST 2- - (� 1 16
W
Plan check f22 UTILITY CO.NOTIFIED z
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINALAA
Plan cheek applicant PLAN CHECK VALIDATION U
Name
Address
/0/7-79 70P 4"a 7- Ti:;-5'7-
City
i:-5'7 City Tel.No.. 7 Petr 6f(e '9;?'_'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE n
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY.WITH ALL COUNTY ORDINANCES N
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION }} _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # O o 0 o o 5
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 2 0 0 5 5 O O
PROPERTY.
SIGNATURE �` /� /!(p_ .J o o o 55 0(J L
OFPERMITTEE
DIST NO. - ESSED BY 9- 19
V
INDUSTRIAL
WASTE APPROVAL