HomeMy Public PortalAbout9543 BLACKLEY ST_Plumbing__ 17
76AG67-CE#817 10-62
APPLICATION FOR PLUMBING' PERMIT .
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS .S'4,_j A
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
i FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER •
WATER CLOSET $1.25 MAIL
/ BATH,TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO:
2— LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO. 7`� �5
LAUNDRY 'IUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. / COUNTY
CLOTHES WASHER 1.25 DISTRICT NO. GR N P SSED BY
WATER HEATER 1.50
i
GAS SYSTEM ` OUTLETS 1.50 INDUSTRIAL d
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD A V
vv
/�� _ !! ✓ l� -- i i W
0J1 -�:/A 'n/�1, V1
Az /(i
/ c I' 7, _ '•f��r�is z
ll f 9
APPROVALS DATE INSPECTOR'S SIGNAi URE
PERMIT 5 2 00 UNDER SLAB WORK 6.1�/?-7 1 `" il7d
ROUGH PLUMBING l r Pr / F/„
TOTAL FEE 0O 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.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES g 4
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ��,y,r//ff�� JJ'
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO OOO' u�� 1 �D7/
RESIDE IN,THE ABOVE DESCRIBED SIDENTIAL PROPERTY UTILITY CO. NOTIFIED O pp V
SIGNATURE ' •/J.� Rn�� A, 4 A
OF PERMITTEE FINAL � v/- Vv
LIDATION ROBERT A. WOOD-
CK M o CASH SUPERVISING M�CHI4NICAL ENG'R
tip 0 5 5 3 8 JUIN 3 5- D•' 1 5.x.10
76A667 -CE#817 2-62 TEMPLE CITI-
i
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONBUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
_-- CROSS ST. A- L
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25
BATH TUB 1.25 ADDRESS p��L
SHOWER 1.25 CITY e> f�e ja2e t4P TEL. NO.
LAVATORY 1.25
CONTRACTOR
i
SINK 1.25 ADDRESS ,�
DISHWASHER 1.25 CITY _-. TEL. NO. _
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE CESSED BY
WATER HEATER 1.50 �/ D ( U
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
—-- — (�
V
V
W
tnt
I
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
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL 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 I AM THE LEGAL OWNER OF.AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBE EENNNTTIALL ROPERTY. UTILITY CO. NOTIFIED
SIGNATURE ---
OF PERMITTEE FINAL
n
VALIDATION ROBERT A. WOOD
M J. CASH SUPERVISING MECHANICAL ENG'R
1