HomeMy Public PortalAbout9710 DAINES DR_Plumbing__ r. t1
76A66
DBS-17
10-58 " APPLICATION LICB"',TION FOR PLUMBINGY„PLUMBING1116eRMIT 1
BS-17
WVTSION OF BUILDING AND SAFETY
Department 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 . DISTRO GR I ZONE I READY FOR INSPECTION
MAIL
ADDRESS Al
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY ...s TEL NO
LICENSE NO 141`Ic)
s
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00
BATH TUB @ $1 00
SHOWER @ $1 00
LAVATORY (WASH BASIN) @ $1 00
KITCHEN SINK @ $100
DISHWASHER _ _@ $100
LAUNDRY TUB OR TRAY @ $100
CLOTHES WASHER @ $1 00
WATER HEATER @ $100
GAS SYSTEM @ $1 00
APPROVALS
ATEA 1 SPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 7 00 ROUGH PLUMBING )
/ GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT IHAVE 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 FIXTURES A
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED 3/A)
DESCRIBED RESIDENTIAL O E %i.—
SIGNATURE F v.+o 16L
OF PERM ITTEE AL
JOHN A LAMBIE, COUNTY ENGINEER ALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
111 0 CASH
cR i 1 9`1 9In SEP 3 3 1 1 .0 0 2
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