HomeMy Public PortalAbout9179 JAYLEE DR_Plumbing_9/5/1978_dishwasher I`
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aPPLOC ATO FOR PLUMBONG PIER T �.
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 91K7
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET LOCALITY i
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAI(
ADDRESS
SINK CITY TEL.N .
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
p CITY EL.NO. >d,:7d
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER LICENSE NO. / CLASS
� DISTRICT NO. P I'L51E ES ED
GAS SYSTEM OUTLETS Q
l d
OUTLETS OVER O
5 PER SYSTEM INDUSTRIAL V
WASTE APPROVAL
INSPECTION RECORD
V
W
a
C/J
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE$ D
TOTAL-FEE
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I`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 -
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DE7R1,,"ISIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED '
SIGNATURE O O O
OF PERMITTEE FINAL 10
_ O
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATOON9D QM.O. CASH
J O O a`-Rl—
CD
C O rs
CH