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HomeMy Public PortalAbout9022 JAYLEE DR_Plumbing_4/5/1979_gas system 76A667A v CE,81 7(REV.6/78) ©5'! APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINS C o Z 2 ? Yc FF q, NUMBER FIXTURE OR ITEM @ FEE ADDRES �f WATER CLOSET LOCALITY 5-14A, `^L A l W ILC►a NEAREST /� BATH TUB CROSS ST. F�/'FR(7 It SCI L T -1 W4 SHOWER OWNER C RNfST I �,�f (` t�YL11, LAVATORY MAI L ADDRESS t SINK CITY TEL.NO. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING 0. GAS PIPING d GAS VENT V OC HOT WATER HEATER C PLUMBING FIXTURES GAS TEST N Plan check fee UTILITY CO.NOTIFIED Z PLUMBING PERMIT ISSUING FEE$ TOTAL FEE , FINAL Plan check applicant PPLLAANN�CHECK VALIDATION < ) Name s ngnra — Address oz-L F J�I�cF� DR. ,yam/ _. y� F //' 5� P357,8A City5AN 4'1+48!2!lC Tel.No.Zg��7 �S 7r '` D121a"'Idi Z-'' F # • • • • • 5j I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2 - 8 1 0 0 0 AND STATE LAWS"REGULATING PLUMBING. PERMIT VALIDATION (� I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS '� r - T 0.0 0-- REQUIRED BY LOS ANGELES'.000NTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND-T.O RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 0&05-79 PROPERTY. '- SIGNATURE OF PERMITTEE DISTRICT NO. /' PROCESSED BY v / INDUSTRIAL WASTE APPROVAL