HomeMy Public PortalAbout9157 JAYLEE DR_Plumbing_8/15/1978_fixtures 76A667A ICE 817Bi.-4/77
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRE /
NUMBER FIXTURE OR ITEM ® FEE SS
WATER CLOSET LOCALITY
BATH TUB NEAREST CROSS ST.
SHOWER OWNER
/ LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR '� e L_ uN 14
Qa
CLOTHES WASHER ADDRESS ! /2 L
SWIMMING POOL RECEPTOR
CITY`T?,,..l/Df C� � r'T�� TEL.NO, Z S'l >-I y.3
LAWN SPRINKLER SYSTEM
STATE - LIC.
Z
WATER HEATER LICENSE NO. � � CLASS
GAS SYSTEM OUTLETS DISTRICT NO. G UP ZONE PROC ED BY
0 .
OUTLETS OVER CD
00 CD
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL 0 CC
INSPECTION RECORD 0
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Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
IHEREBY 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
IHEREBY 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�INTE 'TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIALPROPERTY. UTILITY CO.NOTIFIED
SIGNATURE -"OF PERM ITTEE � -� FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI N , CK.!' M.O. CASH
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3 0 9 AUG 1 a 5 a 1 6.0 0 �=