HomeMy Public PortalAbout9708 DAINES DR_Plumbing__ oa568710.54, APPUCATION F®P P@�l�MMIG PERMIT
DIVISION OF BUILDING AND SAFETY
:';Deportment of County Engineer -„ .�.;,
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER `DISTRIECTO.^ GROUP IZONE1 I READY FOR INSPECTION
MAIL ',�•)y_
F ADDRESS
4'
CITY TEL. NO. INDUSTRIALWASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CIT TEL. N -
LICENSE NO.
r
NUMBER
TYPE OF FIXTURE OR ITE FEE
Q� WATER CLOSET (TOILET) @ $1.00 $
{� BATH TUB @ $1.00
/ SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00 ;
KITCHEN SINK @ $1.00
-h. DISHWASHER @ $1.00
a
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
D TE N ECTOR'S SI#NATURE
c ?. UNDER- WORK Q,�.pa�� �v'•
PERMIT $ 0O '” ROUGH PLUMBING
GAS PIPING
TOTAL FEE
GAS VENT
I HEREBY ACKNOWLEDGE THAT 1- HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST T L�J,✓� .—� ^':/Ly
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIPR P TY.
SIGNATURE
OF PERMIT' NAL ' j
JOHN A.A. LAMBIE. COUNTY ENGINEER ALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. m.0. CASH
�: 19 :1 8 SEP 3 1 1 .Q 0 M
r