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HomeMy Public PortalAbout9078 LYLEDALE ST_Plumbing__ 76A667C ICE 617A) 1 1/76 APPLICATION ®PgCA 0ON FO' ®�®LV nO- lNG PERMIT -- - COUNTY E®MIT _COUNTY ` OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEER BUILDING,AND SAFETY DIVISION J FOR APPLICANT TO FILL IN(PRINT OR TYPE) gDIDRESS. V�� �/ry�� eZ NUMBER FIXTURE OR ITEM @ FEE WATER.CLOSET LOCALITY C a NEAREST BATH TUB CROSS ST. �J(� �✓A �•��/ 6-� SHOWER. OWNER' 'I ICp / //747_ fl%e L LAVATORY, ADDRESS/G7p L•��l®�l/� # SINKe5_ yCITY TEL.NO'_33; DISHWASHER CONTRACTOR CLOTHES WASHER .• ADDRESS (J% SWIMMING POOL RECEPTOR- CITY TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS DIIuCT NO._ ;(YRQ AROCEb BY a OUTLETS OVER 5 PER SYSTEM INDUSTRIAL 9L WASTE APPROVAL INSPECTION RECORD V ku O W Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address. ROUGH PLUMBING City Tel No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT - THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I .I HEREBY-CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY,LOS ANGELES COUNTY AND STATE OF CALIFO IA OR THAT I AM THE GAS TEST. LEGAL OWNER,OF,AND I END TO R SIDE IN THE ABOVE SCRIBED RESIDENTIAL - PROPERTY. " TILITY CO.NOTIFIED /yyy SIGNATURE, OF PERMITTEiS FINAL F J PLAN CHECK V L•I DATION CK. M.0., c PERMIT VALIDAT N CASH x+) A1 5 ©S 76A667-CES17 7-59. APPLICATION FOR PLUM G PE M4T COUNTY OF LOS`ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS lc.tFs CASSATT D. GRIFFIN, Sup't'of.Building LOCALITY FOR APPLICANT'TO FILL IN` =4 NEAREST CROSS ST: / NUMBER. - FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ADDRESS :CITY TEL. NO. SHOWER CONTRACTOR DON'S PLUMBING SERVICE LAVATORY ADDRESS 840 S®a Baaldw' in Avenue SINS CITYAftadica, C�,i$NO._ Ni 7-0882 DISHWASHER CONTRACTOR'S STATE f LAUNDRY TUB REGISTRATION NO. �'� COUNTY [l CLOTHES WASHER DIISST�RI N GR / NE R E B WATER HEATER LJ/ ls`3 ✓ �✓ GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD .. _ f 9 9.9_./Z s,... A rk., .i,!rgob�yV��,.• p @" $1.00 PER ITEM $ I L ) _ 6 / �kJ� r✓."C `/t E if C-K FIXTURE . OR APPROVALS DATE INSPECTOR'S SIGNATURE �- PERMIT $ Z 00 UNDER SLAB WORK_ ��`�Y/ /• t/�ni.✓(lJ ./ fa:CYA TOTAL FEE I /P Ij) ROUGH PLUMBINGU. . (•� GAS PIPING AHEREBY_ACKNOWLEDGE._THAT I HAVE _READ__AGREE TO - .- AND STATE THAT THE ABOVE-IS CORRECT-"AND GREE TO COMPLY". GAS-VENT' WITH ALL COUNTY ORDINANCES. AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER ` 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES CE LINSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GP,S TEST CALIFORNIA OR THAT 'I AM' THE LEGAL OWNER OF, THE ABOVE _ DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.-NOT[FIED SIGNATURE .OF PERMITTEE "` • FINAL ®e ALIDATION ROBERT A. WOOD, M.0. CASR SUPERVISING MECHANICAL ENG*R {{ r �t