HomeMy Public PortalAbout9721 DAINES DR_Plumbing__ 76 � APPLICATION FOR PLUMBING PERMIT
DBS-17.I7' VISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING � �j
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS .T
CASSATT D GRIFFIN SUPT OF BUILDING
LOCALITY
FOR APPLICANT T9 FILL"IN NEAREST
CROSS ST
OWNER DISTRICT NO_ GRO P ! ' NE, I READY FOR INSPECTION
MAIL /
ADDRESS
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE
r WATER CLOSET (TOILET) @ $1 00
BATH TUB @ $1 00
SHOWER @ $1 00
LAVATORY (WASH BASIN) @ $100
KITCHEN SINK @ $100 )
DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $1 00
WATER HEATER @ S100
GAS SYSTEM @ $1 00
APPROVALS
E NSPECTOR'S SIG ATURE
i
UNDER WORK
PERMIT $ 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE zz GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES_
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST I?
LIQENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF /
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED _ n
DESCRIBED RESIDENTIAL ROP Y d
SIGNATURE
OF PERMITTEE
JOHN A LAMBIE, COUNTY ENGINEER LIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
0 CASH
1 9 2 4 SEP"
3 3 1 1 .0 0