HomeMy Public PortalAbout9411 BLACKLEY ST_Plumbing__ 76A667-CE#817 10-62 �/� y _
APPLICATION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ADDRESS y �
JOHN A. LAMBIE, COUNTY ENGINEER ✓
WILLIAM A. JENSEN, SUPT OF BUILDING 7_,Y
LOCALITY
FOR APPLICANT TO FILL IN NEAREST 4 L SS /c In
NUMBER FIXTURE OR ITEM EACH FEE OWNER L .4 k i_ M, �-
WATER CLOSET $1.25 MAIL G�i,��7 37-
BATH
BATH TUB 1.25 ADDRESS - y, CJ 7
SHOWER 1.25 CITY Lt TEL. NO. /CLQ
LAVATORY 1.25 CONTRACTOR w ''ER
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ElREGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. G:r ZONE P C 55 Y
WATER HEATER 1.50 'J 0
IL
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL C
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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 FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
VALIDATIOROBERT A. WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
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