HomeMy Public PortalAbout9174 JAYLEE DR_Plumbing_10/13/1961_gas syst 76A607-CE817 10-60
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 7BUILD��Nl;JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN. SUPT of BUILDINGFOR APPLICANT TO FILL IN
NUMBER FIXTURE OR ITEM OWNER '
WATER CLOSET MAIL
BATH TUB ADDRES C
CITY TEL.
SHOWER
LAVATORY CONTRA OR � �
SINS ADDRESS
DISHWASHER CI TEL. NO.
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. Vgtj el COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZONE SEED BY
WATER HEATERIz o 6
GAS SYSTEM ���`� WASTE R
WASTE APPROVAL }
INSPECTION RECORD O
V
�0�--
W
0-
to
Z
e� $1.00 PER ITEM j
OR FIXTURE $ t APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2OC UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER,
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURE
LICENSED AS REQUIRED By/ S ANGELES COUNTY AN STATE OF
CALIFORNIA OR THATP_}P-y`/ THE LEGAL OWNER OF THE ABOVE GAS TEST
DESCRIBED RESIDENTI ROPERTY. UTILITY CO. NO IED
SIGNATURE
OF PERMITTE ^�
FINAL
VALIDATIO7y/�7�y D ROBERT A. WOOD
I CK. M.0. \� SUPERVISING MECHANICAL ENG'R