HomeMy Public PortalAbout5605 A & B WELLAND AVE_Plumbing__ 76A667,4 • . o
GE 171REW 15/78)
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS vP9 Nr �oeol9A 0
NUMBER FIXTURE OR ITEM ® FEE
WATER.CLOSET LOCALITY r*/fp4,E
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER Qe44k
LAVATORY ALArHIADDREss V79 iA-'Old W4Y
SINK ��. CITY TEL.NO.iplW3/ff
p{L DISHWASHER CONTRACTORy�(
OL. CLOTHES WASHER ADDRESS..., �p &9/✓�
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SWIMMING POOL RECEPTOR
CITY e&y,,.m TEL.NO,�,(,�.3�.3�'
LAWN SPRINKLER SYSTEM STATE LIC:.
,,t- WATER HEATER
LICENSENO.. cS�O?��� CLASS
GAS SYSTEM OUTLETSAPPROVALS DATE INSPE T IGNATURE
OUTLETS OVER 41 UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING 4ZZ72
GAS PIPING
GAS VENT u
HOT WATER HEATER ,®
PLUMBING FIXTURES
GAS TEST _/40 12 us
Platt Check fee UTILITY CO.NOTIFIED z
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL "y
Plan check applicant
PLAN CHECK VALIDATION
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Name �� 2r`.li�n
Address 'ace 010CA OR
City Tel.No.
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 ;25310 A
I HEREBY CERTIFY THAT'I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE o o O o 0 5
LEGAL.OWNER OF.AND INTEND TO RESIDE IN THE:ABOVE DESCRIBED RESIDENTIAL
PROPERTY' '
�,��/J��Q�' 2 0 0 97.00
SIGNATURE �� a<1
OF PERM ITTE O O O 7n
1.b C U
DISTRICT NO. PRO ED BY
0709,-,79
INDUSTRIAL
WASTE.APPROVAL