HomeMy Public PortalAbout9026 ACASO DR_Plumbing_3/23/1971_gas system, outlets 76 A7—CE 817 8/68 //� __ / a4�7
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APPLICATION FOR PLUMBING PER a IT jl
COUNTY OF LOS ANGELES LII
DEPARTMENT OF COUNTY ENGINEER /
BUILDING AND SAFETY DIVISION ADDRESS BUILDING 90 !�
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY ?
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST e
CROSS ST. J
NUMBER FIXTURE OR ITEM EACH FEE
OWNER�
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRESS �L7 aLrZ�-
SHOWER 1.50 CITY &;e-1 TEL. NO.A ^Aq3
LAVATORY 1.50 CONTRACTO
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY ' TEL.1'10.
CLOTHES WASHER 1.50 STAiELIC —3
LICENSE NO.11171� CLASS C
SWIMMING POOL RECEPTOR 1.50
DISTRICLAWN SPRINKLER SYSTEM 2.00 ®Tl GROyP ZONE PRO ES D BY O
'',WATER'HEA'TER 1.50 INDUSTRIAL
WASTE APPROVAL o
GAS SYSTEM OUTLETS 1.50 ` ; INSPECTION RECORD 2
OUTLETS OVER
c.:)
5 PER SYSTEM .30 d
Z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL AL FEE ,� APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant ' UNDER SLAB WORK
Name ROUGH PLUMBING
Address
GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES_ AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OW ER OF,AND INTEND TO 11,7
RESIDE IN, TME ABOV EiCRiB D RESIDENT. LL PROPERTY. FINAL ,7
N
SIGNATURE JACK R. ALLEN, SU RVI IN'G MECHANICAL G'R.
OF PERM ITTE
PERMIT VALIDATION CK. M,.- CASH
PLAN CHECK VALIDATION CK. M.O. CASH