HomeMy Public PortalAbout9588 BLACKLEY ST_Plumbing__ 76A667 (f°E-817) - 175 `\``--. f ✓
APPLICATION . OR PLU BING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION TADDRESS
DING
MAKE CHECKS PAYABLE TO:
HARVEY T. BRANDT, COUNTY ENGINEERAFOR APPLICANT TO FILL IN (PRINT OR TYPE) REST
SS ST.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET '
2.00 OWNER G)
MAIL `
BATH TUB 2.00 AP
DRES
SHOWER 2.00 CIT TEL. NO.
LAVATORY 2.00 CONTRACTOR V
SINK 2.00 ADDRES
DISHWASHER 2.00 CITY1 ��Q, � TEL. N0.
CLOTHES WASHER 2.00 STATELICENSE N3�y � CILASS .5�
SWIMMING POOL RECEPTOR 2.00 3 OL?
DISTRICT NO. OUP ZONE PR CESS D BY
LAWN SPRINKLER SYSTEM 2,00 6"O 9
d
WATER HEATER 2.00 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00 V INSPECTION RECORD a}
OUTLETS OVER CD
5 PER SYSTEM .30 — � :� �+ .- iJ���^v V
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ .THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES �]
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LY
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCBE ESI EN IAL PROPERTY,
FINAL
SI G N A TLI RE•
OF PERMITTEE
PERMIT VALIDATION M.0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
6 2 O cTIAR 9 5 U 1 6.5 0 ,&-K,
76A667 -CE#817 2-62
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES Lot 1-7` 5
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS 9588 E. Blackie
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN NEARESTSJ
CROSS T.
NUMBER FIXTURE OR ITEM EACH FEE
,17
WATER CLOSET $1.25 3 75 OWNER JMAIL * B. Weber De a Co.
1 snrx rus 1.25 1 25 _ADDRESS 5926 N, Temple City Blvd,
2 SHOWER 1.25 2 50 CITY Tem le City TEL. NO.
4 LAVATORY 1.25 5 pp CONTRACTOR Valley Plumbing Co.
1 SINK 1.25 1-125 ADDRESS 4.42 W. Fleetwood Place
1 DISHWASHER 1.25 1 25 CITY Glendora, TEL. NO.Ed 51293
LAUNDRY TUB 1.25 CONTRACTOR'S El '
REGISTRATION NO. 209/x.31 COUNTY ❑
1 CLOTHES WASHER 1.25 1 25 1 DISTRICT NO. GROUP ZONE PROCESSED BY `
1 WATER HEATER 1.50 1 5p Q
1 GAS SYSTEM OUTLETS 1.50 1 50 INDUSTRIAL
WASTE APPROVAL
1 OUTLETS OVER 5 PER SYSTEM .30 30 INSPECTIONN RECORD
a
U1
APPROVALS DATE,, INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00
ROUGH PLUMBING '�� �j�,• �e;
TOTAL FEE 21 55 GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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 n iG
PLUMBING. _
I HEREBY CERTIFY THAT I 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 IGAS TEST
NTEND TO
RESIDE IN,THE ABOVE DESCRIBED SIDENTIAL PROPERTY UTILITY CO NOTIFIED � �4/ :nr AW
• =
SIGNATURE _ 1 _
OF PERMITTEE FINAL 3' !'9 e+.�'g®1lDW,
/yALIDATION ROBERT AJ WOOD
/l c✓KJ M O CASH SUPERVISING MECHANICAL ENG'R
L�vo4 3 8 9Z-a SEP 29 5 D 2 1.55~ d