HomeMy Public PortalAbout9829 1/2 LEMON AVE_Plumbing__ 76 A 667—CE 817 8/68
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER '
COLEMAN W JENKINS. SUPT OF BUILDING LOCALITY
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FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST. v J
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1 50
MAIL J
BATH TUB 1.50 ADDRESS
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SHOWER 1.50 CITY / n TEL. NO,#t&r dJj
LAVATORY 1 so CONTRACTOR
SINK 1 50 ADDRESS
DISHWASHER 1.50 CITY TEL. NO 770
CLOTHES WASHER 1 50 STA E LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO GROUP �E CESSED BY
LAWN SPRINKLER SYSTEM 2:00 S 1_7+ A A.__ CD
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,WATER.HEATER 1 50 � INDUSTRIAL v
WASTE APPROVAL Z
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD OF.
OUTLETS OVER ** LULU
5 PER SYSTEM 30 J� rQ G, �C N
Z
Plan check fee 25 of above See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE J APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB'WORK
Nance 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
PLUM BING
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 D! RIBED RESIDENTIAL PRO PE RTV FINAL /
SIGNATURE �A JACK R. ALLEN, SUPERVISING MECHANICAL-E FTG
OF PERMITTEE 6""�"�V /
PERMIT VALIDATION CK M CASH
PLAN CHECK VALIDATION CK M O CASH
i �'� . .7 7&— DEC 2 h 3.50-
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