HomeMy Public PortalAbout9063 RANCHO REAL RD_Plumbing_1963-12-23 '76A667-CE#617 5/63 : �;•
APPLICATION FOR PL MBINC IdERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING.
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS' ncl a
WILLIAM A.JENSEN,SUP'T OF BUILDING LOCALITY
9063 Em Tmpla City.
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE '
OWNER
WATER CLOSET $1.25 Om Hankwn3!th
MAIL
1 BATH TUB 1.25 1 ADDRESS; '111 W-ldfl r
SHOWER 1.25 - CITY Tem le•Ct ' TEL,NO. 4484367
1 LAVATORY 1.25 1 CONTRACTOR Belvedere Plumbing 00.'A
1 SINS 1.25 125
ADDRESS 13350 Ector
DISHWASHER 1.25 -*CITY :C3t .. f IndUSt TEL. NO. GI 898J6
CTOlt' STATE
LAUNDRY TUB 1.25 EI
GN S�TRAT ONSNO. 179568 COUNTY p
1 CLOTHES WASHER 1.25 �, DISTRICT NO GROUP ZONE PROCESSED BY
WATER HEATER 1:50 •�
GAS SYSTEMlj__OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .90, INSPECTION RECORD U
APPROVALS DAT . INS CTO 'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK, /
ROUGH PLUMBING'
TOTAL FEE 3,1
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION �x
ANDGAS VENT. STATE THAT THE ABOVE IS CORRECT AND AGREE TO. COMPLY zh
WITH ALL COUNTY ORDINANCES AND STATE -LAWS REGULATING
PLUMBING. HOT WATER HEATER P
1 HEREBY CERTIFY THAT I AM'PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GASTEST -
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE AS
QVE DESC RESIDENTIAL PROPERTY. CO.NOTIFIEDr I
UTILITY ! !'
SIGNATURE `�' _ ✓
OF PERM ITT
`
FINAL 4AIRAI'Al
�,
' - _ ATION ROBERT A.WOOD
r CK. M.•O. 'CASH SUPERVISING-MECHANICAL ENG'R
LjiCo 3 7 8 4 G 'DEC 2 3 5 D 11.2.5-