HomeMy Public PortalAbout9174 JAYLEE DR_Plumbing_10/4/1972_gas syst 76A667 (C E-817)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS 112 AL/00
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
r
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. /CT
NUMBER FIXTURE OR ITEM @ FEE
OWNER �-f^
WATER CLOSET 1.75
MAIL i{ A` /� n
BATH TUB 1,75 ADDRESS '!' L (/
SHOWER 1.75 CITYe/Mn r `C TEL. NO. -
LAVATORY 1.75 CONTRACTOR �. G V j
SINK 1.75 ADDRESS 3 / �1G((/� ew✓jf
DISHWASHER 1.75 CITY /2 Gf. 4A TEL. NO.
CLOTHES WASHER 1.75 STATE LIC
, CJ 3 /�O ` S
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. CLASS
DISTRICT NO. G OUP/// ZONE FROCESS D BY
LAWN SPRINKLER SYSTEM 1.75 4;_1 ale
WATER HEATER 1.75 INDUSTRIAL /
WASTE APPROVAL
GAS SYSTEMOUTLETS 1.75 7 1 NSPEC TI ON REC ORD
OUTLETS OVER
5 PER SYSTEM .30 C
H
V
W
h
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE q- 7`✓
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
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
PLUMBING. _ GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR TH THE LEGAL OWNER F, AND INTEND TO
RESIDE IN OR
VE DES IBED RESIDE ROPER TY FINAL
SIGNATU REQ
OF PERMITT
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.0. CASH„
9 0 4 5 Q 4.75