HomeMy Public PortalAbout9858 FLAHERTY ST_Plumbing__ ' � f
76A667 - CE 817 7-69
APPLICATION FOR . PLUMBING PERIVII,
COUNTY,OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER _
BUILDING AND SAFETY DIVISION fDDRESSILDING 118,5-9 L f-/FST
JOHN A. LAMBIE. COUNTY ENGINEER COLEMANtW. JENKINS. SUPT OF BUILDING CALITY TEMPLEFOR APPLICANT TO FILL IN•(PR NT'OTYPE)' ARESTv0OSS ST. (�� L L t l/fF-
NUMBER FIXTURE OR ITEM EACH FEE -
OWNER M R d !tin a
WATER CLOSET 1.50 Q MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 ? s(� CITY TEL. NO.
(, LAVATORY - 1.50 CONTRACTOR f ,
SINK 1.50 ADDRESS �Lcs'-S S•��t/QG? %.
-DISHWASHER 1.50 CITY TEL. NO.ZV—1
CLOTHES WASHER 1.50 STATE - CLASS
IC
LICENSE NO I �. -
SWIMMING POOL-RECEPTOR 1.50
FINDUSTRIAL
GRO P ZONE P O SS Y
,LAWN SPRINKLER SYSTEM 2.00
WATER HEATER 1.50 L
GASSYSTEM OUTLETS 1.50 ( S(/ INSPECTION RECORD
OUTLETS OVER' •.:30 O
S PER SYSTEM
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 5 2 00'!
TOTAL FEE d APPROVALS DATE INSPECTOR'S SIGNATURE
che,/c�k applicant �T" - UNDER SLAB WORK 'a ,`'�`.,r -
Name (/� \Z (Y•s( ROUGH PLUMBING
,GAS PIPING
Address �4/f� �}"L� (�/�V !,
City, � ��C�'T Tel: No.�L - y! GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATI I ��' /� G.
'AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY UMBING FIXTURES (I d
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING:
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED, BY LOS ANGELES COUNTY AND STATE-OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,A D IN END TO / l/
RESIDE IN,THE ABO E DEDCRIB RESIDEN IAL PR P V FINAL
SIGNATURE
/�/E/esu JACK R. ALLEN, 5UPERVISI HANICAL ENG-R.
OF PERMITTE v -
PERMIT VALIDATION CK. M O CASH
PLAN CHEC ALIDATION K M O CASH
4- i'1AR 2 5 D', 0 .