HomeMy Public PortalAbout9435 BLACKLEY ST_Plumbing__ ///?J� ^�
78A687.0 E#617 10.62 /L. `/ 1 d
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 3�
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN RNEAREST
SS ST
NUMBER FIXTURE OR ITEM EACH FEE /
OWNER
WATER CLOSET $125 MAIL
BATH TUB 1 25 l) ADDRESS
CITY TEL NO
SHOWER 1 25
LAVATORY 125 U CONTRACT
SINK 12,5 ADDRESS
DISHWASHER 125 CITY // TEL NO.
STATE
LAUNDRY fUB 1 25 REGISTRATION NO C°3 6 02e G-3 COUNTY ❑
CLOTHES WASHER 1 25 55
d, DISTyRI,T NO GROUP N P GRCCE'SSED BY/
WATER HEATER 1 50 if �j r. l`.'ol
GAS SYSTEM OUTLETS 1 50 INDUSTRIAL d
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM 30 D INSPECTION RECORD V
W
y
z
ov n
APPROVALS DATE
INSPECTOR S SIGNATURE
PERMIT $ Q O UNDER SLAB WORK
S ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY q /►.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER 7� ^
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES "el, Yw,
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFGAS TEST T111 ?y�,
CALIFORNIA OR THAT f AM THE LEGAL OWNER OF AND INTEND TO �I}/ At�fl�`
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE '-N rt 4 r fA
OF PERMITTEE FINAL
LIDATION ROBERT A WOOD
cK M o CASH SUPERVISING MECHANICAL ENG R
LACO43251 JAN13 5- A 15.00