HomeMy Public PortalAbout9338 BLACKLEY ST_Plumbing__ 76A667-CE4817 6-65 7 6110 .' Cr
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS Q
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY I
C
FOR APPLICANT TO FILL IN NEAREST
CROSS ST X
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1 25 j MAIL
BATH TUB 1 25 ADDRESS
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINK 1 25 ADDRESS
DISHWASHER 125 !�q CITY C L,j TEL NO, �f���
STATE I., LIC
LAUNDRY TUB 1 25 11 LICENSE NO (� CLASS
CLOTHES WASHER 125 DISTRICT NO GROUP ZONE PROCESSED BY
WATER HEATER 1 50
so
GAS SYSTEM OUTLETS I WAINDSSIAL CL.
EEAPPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 ECTION RECORD V
i 0
H
V
Lu
CL
Z
APPROVALS DATE INSPECTOR 5 SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK �,� v�f .dC �sJ9
ROUGH PLUMBING r
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM OINTEND TO T E LEGAL OWNER F A
RESIDE IN THE ABOVE 6CR SIDE NTIAL P OP Y UTILITY CO NOTIFIED
SIGNATURE f "-^+
OF PERMITT FINAL /�j' `"vL��~��
�ALIDATTON /
CK M O CASH
�FIU� 9 4 5 FAY 11 5 D 12.50-
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