HomeMy Public PortalAbout9174 JAYLEE DR_Plumbing_9/12/1972_swimming pool 76•.11667-CE'8*617 10-67 �l It-,
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS A Ir-, ®A� -
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Cl
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER S.
WATER CLOSET 1.50 MAIL / /7n
BATH TUB 1.50 ADDRES 17/71/, 6�e P 6
c
SHOWER 1.5o CITY �� TEL. NO. —�
LAVATORY 1.50 CONTRACTOR Q'14f
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY '�/ TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO: .- CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT 0. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00 - �/OV P�� /4`� /.7(�{�. d
O
C-3
INDUSTRIAL
WATER HEATER 1.50 WASTE APPROVAL
CD
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD U
OUTLETS OVER
5 PER SYSTEM - .30 --7 r N
7r
r -77e j QA
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Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 9 00
TOTAL FEE O 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
IH
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 RTIFY THAT I'AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSE�T:H.RAIIIO
REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFOROTHAT I M THE LEGAL OWNE O�E�
RESIDE I SCRIBED RESIDE NTI P -
FINAL
SIGNATURE �� JACK R. ALLEN, SUPERVISING ' ANICAL EN G'R.
OF PERMIT
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALID AT CK. M.O. CASH
Liu,u 7 0 6 SEP 12- 5 D6.10CQ