HomeMy Public PortalAbout9564 BLACKLEY ST_Plumbing__ 76A667 -CE#B17 2-62
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES Lot # g
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION fB
DDRESS 956/i E. Blac?ale 5t.
JOHN A. LAMBIE. COUNTY ENGINEERWILLIAM A. JENSEN. SUPT OF BUILDINGOCALITY Tem-ple City
FOR APPLICANT TO FILL IN EARESTJROSS ST. tEzaNUMBER FIXTURE OR ITEM EACH FEEOWNER J. B. Vleber Dev. Co.
3 WATER CLOSET $1.25 3 75 MAIL
2 BATH TUB 1.25 2 50 ADDRESS 5926 N. Temple City Blvd.
l SHOWER 1.25 1 25 CITY Temple City TEL. NO.
CONTRACTOR Valley Plumbing Co.
3 LAVATORY 1.25 3 75
1. SINK 1.25 1 25 ADDRESS 442- W. Fleetwood Place
1 DISHWASHER 1.25 1 25 CITY Glendora TEL. NO. Ed 51293
CONTRACTOR'S STATE ❑
LAUNDRY TUB 1.25 1 REGISTRATION NO. 2094.31 COUNTY
1 ❑
1 CLOTHES WASHER 1.25 25 DISTRICT NO. GROUP ZONE PROCESSED BY
1 WATER HEATER 1.50 1 550 of
1 GAS SYSTEM OUTLETS 1.50 l 50 INDUSTRIAL
WASTE APPROVAL
Z OUTLETS OVER 5 PER SYSTEM •90 30 INSPECTION RECORDIL
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APP ALS DATED INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER-47 WORK /b/G
ROUGH PLUMBING
TOTAL FEE 20 130 GAS PIPING I f� !1 - cam✓ y ��
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT "
AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY w ;JA
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER f ..✓� v;
PLUMBING.PLUMBING. '
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1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES V
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LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST Q G
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO ��p g /--
RESIDE IN,THE ABOVE DESCRIBED R SIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE f� r y
OF PERMITTEE FINAL
ALIDATION ROBERT A. WOOD v r r 1
c M D CASH SUPERVISING MECHANICAL ENG'R,
L ,L;o4 3 8 4Zoir SEP 29 5 D 2 0.30