HomeMy Public PortalAbout9173 JAYLEE DR_Plumbing_2/4/1973_water heater, gas syst 76A667 (CE-817)-4/72
APPLICATION �PLYMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Eb
BUILDING AND SAFETY DIVISION BUILDINGLT-
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) - NEAREST
NUMBER FIXTURE OR ITEM @ I FEE CROSS ST.
OWNER
WATER CLOSET 1.75
MAIL
BATH TUB 1,75 ADDRESS
SHOWER 1.75 CITY TEL. NO.
LAVATORY 1,75 CONTRACTOR
SINK 1,75 ADDRESS
DISHWASHER 1,75 CITY � TEL. NO.1331-Or
CLOTHES WASHER 1.75 STATE 7 ^ LIC
/ /
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. CLASS
DIST ICT NO. GROUP NEOCESSE BY
LAWN SPRINKLER SYSTEM 1,75 i
WATER HEATER 1.75 �j INDUSTRIAL
WASTE APPROVALCD
0-
GAS SYSTEM /OUTLETS 1.75 / 7 INSPECTION RECORD V
OUTLETS OVER 30 O
5 PER SYSTEM
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address Q ,GAS PIPING l?5—
y �y���l�Q Tel.
NO. ,/J(� GAS VENT
Cit V w
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
PLUM BI N.G. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OW OF, AND INTEND TO -
RESIDE IN THE ABOVE DESCRIBED RE AL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE
PE MIT LIDATION CK. M.0. CASH
PLAN CHECK VALIDATI CK. M.O. CASH
5 .6..8 r FEB 605.0