HomeMy Public PortalAbout9112 OLEMA ST_Plumbing__ 76A667-CE,4817 10-67 1 /`/
APPLICATION TION FOR PLUMIB➢ G PERM` T
COUNTY OF LOS-ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILD NG ADDRESS 9112 2. Olema at
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY rip
em 1e 1
FOR APPLICANT TO FILL IN PR NT OR CROS
TYPE) BY 1,
CROSS ST. Z/a1C]LIlbt? or 1r1Va.a
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 1 OWNER Dale L. Knapp
AIL
BATHTUB 1.50 ADDRESS 9112 ii. Olema
SHOWER 1.50 CITY Temple City TEL. NO. 286-8220
CONTRACTOR
LAVATORY 1.50
SINK 1.50 ADDRESS VYVI
DISHWASHER 1.50 CITY TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GROUP ZONE PROCESSED BY }
LAWN SPRINKLER SYSTEM 2.00Qj
V
WATER HEATER 1.50 INDUSWASTLPROVAL
O
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD V
S W
OUTLETS OVER
5 PER SYSTEM .30 H
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Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE U Igo APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name Dale L. Knapp ROUGH PLUMBING
Address 9112 1,;. Olema St j GAS PIPING
GAS VENT
City ^1 em 1e City Tel. No. 2868220 HOT WATER HEATER
I
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB 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
i CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE D
?C11090 RESIDENTIAL P OPERTY. FINAL
r
i SIGNATURE JACK R. ALLEN, SUPERVISIN ME HANICAL ENG'R.
t OF PERMITTEE ✓
ME-az PERMIT VALIDATION CK. M.O. CASH
1PLAN CFIECK WALIDA'I'ION CK. M.0. CA
4 3 0 5 D GI L 0
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