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HomeMy Public PortalAbout9574 BLACKLEY ST_Plumbing__ 76A667 -CE-#'817 2-62 V APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES Lot 7 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS %c� 574 E. Blackley St.WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST L� NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET $1.25 3 75 OWNER J. B. lleber Dev. Co. 1 MAIL BATH TUB 1.25 1 25 _ADDRESS 5926 N. Temple City Blvd. SHOWER 1.25 5o CITY Temple City TEL. NO. 3 LAVATORY 1.25 31 75 CONTRACTOR Valley Plumbing Co. ]- SINK 1.25 3. 25 ADDRESS 4.4.2 111. Fleetwood Place 1 DISHWASHER 1.25 2 25 CITY Glendora TEL. NO. Ed 51293 CONTLAUNDRY TUB 1.25 REGISTRATION ON NO. 2094CTOR'S '; 1.- STATE ❑ 3_ COUNTY ❑ 1 CLOTHES WASHER 1.25 2 25 DISTRICT NO. GR7O�'UP ZONE PROCESSED BY l- WATER HEATER 1.50 50 So .L I � �i, 1 GAS SYSTEM OUTLETS 1.50 `50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM •90 30 — INSPECTION RECORD APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 O0 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 20 �'0 GAS PIPING ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER '� a PLUMBING. _ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO GAS TEST 0 'u�-, RESIDE IN, THE ABOVE DESCRIB��NTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE - 09 VCKALIDATION ROBERT A. WOOD M J. CASH SUPERVISING MECHANICAL ENG'R u,uu � 3 tic n 5 D 2 0.30- Q �