HomeMy Public PortalAbout9162 JAYLEE DR_Plumbing_2/20/1969_fixtures 76A667—CE8174-68
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES u
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS,
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY• 01
- ,
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50 MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY — TEL. NO. !
LAVATORY 1.5 0 CONTRACTOR
SINK 1.50 ADDRESS /
DISHWASHER 1.50 CITY '- UV' TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 " a m
DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00 •� t
c _ C O
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 �� INSPECTION RECORD O
OUTLETS OVER .30 0
5 PER SYSTEM -
Ld8
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Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE 'lea '
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City" Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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 GAS TEST
PLUMBING.
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 DESCRIBED RE G�NTIAL PRO rL. FINAL
SIGNATURE ` SACK R. ALLEN, SUPERVISING ECH ANICAL ENG-R.
OF PERMITT -�� -�
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
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