HomeMy Public PortalAbout9467 BLACKLEY ST_Plumbing__ 7APPLICATION FOR PLUMBING PERMIT
IDBS 1 I7 DIVISION OF BUILDING AND SAFETY it
Department of County Engineer
County of Los Angeles BUILDING
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS % IU
CASSATT D GRIFFIN,SUP T OF BUILDING
LOCALITY Q i
FOR APPLICANT TO FILL INNEAREST
CROSS ST
OWNER r DISTRICTI GROUP I I READY N&I INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY > TEL NO WASTE APPROVAL
PLUMBER r ,�/cJ "� ;,� INSPECTION RECORD
ADDRESS � +! /' �2 3�a,�- �G �L���-S-
CITY TEL NO
LICENSE NO������
NUMB/ER TYPE OF FIXTURE OR ITEM FEE
/ WATER CLOSET (TOILET) @ $100 $
BATH TUB @ $100
SHOWER @ 3100
LAVATORY (WASH BASIN) @ $100
KITCHEN SINK @ $1 00
DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $100 .O
WATER HEATER @ $1 00
GAS SYSTEM @ $100
APPROVALS
DATE INSPECjOR-S-Si( TURE
UNDER SLAB WORK
PERMIT $ rOO
ROUGH PLUMBING r
� ---
D Q GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
_
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST fd
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE G WNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PR ER /
SIGNATURE
OF PERMITTEE FINAL
JOHN A LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
CK Y 0 CASH
Co 5 4 5 OUE'--� DEC 31 3 8.0 0