HomeMy Public PortalAbout9161 JAYLEE DR_Plumbing_4/20/1978_fixtures a
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS zE
WATER CLOSET LOCALITY
NEAREST
BATH TUB �O ,(
1/ CROSS
SHOWER OWNER
LAVATORY !/ MAIL
ADDRESS
SINK CITY' /C TEL.NO. ,
DISHWASHER CONTRACTOR
` OGu a�b/2
CLOTHES WASHER
ADDRESS 4
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM i
STATE LIC. 4
WATER HEATER LICENSE NO. CLASS
DISTRICT NO. GROUP ZONE RO SE
GAS SYSTEM OUTLETS D BY
OUTLETS OVER {
5 PER SYSTEM INDUSTRIAL' 9
WASTE APPROVAL 0
INSPECTION'RECORD V
cc
Lu
Plan check fee 54WA-0 Ctrs ZO--7 Cl ,4-4- t� '
PLUMBING PERMIT ISSUING.FEE$ )�
TOTAL FEE (JZI
Plan check applicant
APPROVALS DATE - INSPECTOR'S SIJ,
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City TeL No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GASVENT
THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING., HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS �, PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST ' (:f+3a '�H' ��"���
LEGAL OWNER OF,AND INTEND RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL ,
s' PROPERTY. UTILITY CO.NOTIFIED '
SIGNATURE
OF PERM ITTEE FINAL /, 4�
PLAN CHECK VALIDATION a CK. M.O. CASH PERMIT VALIDATION cK. J M.O. CASH