HomeMy Public PortalAbout9541 BLACKLEY ST_Plumbing__ 76A667-CE#817 10.62 /r�z �/J/t
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
-DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION fNE'ARESTULDING
JOHN A. LAMBIE. COUNTY ENGINEER DDRESS
WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
r '•
SHOWER 1.25 CITY TEL.,NO.
LAVATORY 1.25 CONTRACTOR
SINE 1.25 ADDRESS - `
DISHWASHER 1.25 CITYT#. NO., Z
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. COUNTY
CLOTHES WASHER 1.25- DISTR CT N GROUP ZONE" P�SED Y
WATER HEATER 1 50
GAS SYSTEM_�OUTLETS 1.50 INDUSTRIAL d
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 V
� INSPECTION RECORD �
G � IL
Fx
Ld u,_
APPROVALS IDATE INSPECTOR'S SIGNATURE
PERMIT $ 2 QO UNDER SLAB WORK �✓9f a!�� L�Qj�qA
ROUGH PLUMBING �� ,I� -' ✓T
TOTAL FEE
VC, GAS PIPING '
1 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 GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED p a
SIGNATURE 09. `x•��IJJf���/T14
OF PERMITTEE FINAL `�.��y•� V
VALIDATION ROBERT A WOOD
M O CASH SUPERVISING MECHANICAL ENG'R
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76A667 -CE#817 2-62 -TEMPLE LE C97
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
FNARF
INGBUILDING AND SAFETY DIVISIONSS � L�CKGJOHN A. LAMBIE, COUNTY ENGINEERWILLIAM A JENS&, SUP T OF BUILDING LITY G� rFOR APPLICANT TO FILL IN STS ST. C L ov L
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
BATH TUB 1,25 ADDRESS Z
CITY TEL. NO.
SHOWER 1.25
LAVATORY 1.25 CONTRACTORj�
SINK 1.25 ADDRESS
DISHWASHER 1 25 CITY TEL. NO.
CONTRACTOR'S STATE El
LAUNDRY TUB 1.25 REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO rGROUP ZON P4OfESSED BY
WATER HEATER 1.50 _
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 l/ IyNSSPPEE�CTIO�N�RECORD 4h
d
O
o
r
' U
W
Vf
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
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
L
COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
Y CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
A OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO
THE ABOVE DESC RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
REMITTEE FINAL / �!
ALIDATION ROBERT A�WOOD r:
' cK M
0 CASH SUPERVISING MECHANICAL ENG'R