HomeMy Public PortalAbout9115 RANCHO REAL RD_Plumbing_1964-07-18 76A,667 1#817 2.62 TEMPLE CRyy
Y APPLICATION FOR, O.LUMBI.NG PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE:-COUNTY ENGINEER. ADDRESS �g,yl C a- /
WILLIAM A.JENSEN,SUPT OF BUILDING e
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
caosS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNERf
WATER CLOSET $1.25 • �� h
MAIL
BATH TUB 1,25 ADDRESS
r SHOWER 1.25 r zr. CITY TEL. NO.
J LAVATORY 1,25 / 5 CONTRACTOR V O h 11 40op-_
SINS 1.25 ADDRESS 6.2 ,1 a IV P40- rL
DISHWASHER 1.25 CITY C TEL.140. L qjr f6 r
LAUNDRY TUB I.25 CONTRACTOR' /� STATE
REGISTRATION NO. �'� �Z COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSEDBY
WATER HEATER 1.50 o
GAS SYSTEMOUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PEI!SYSTEM .30
J 3NSPECTION RECORD,
[•r ,1 dl 4)
QS
O
APPROVALS DATE INSPECTOR'S SIGNATVJRE
PERMIT S 2 00 UNDER SLAB WORK ,1
ROUGH.PLUMBING
TOTAL FEE 3 GAS PIPING L+`
1 HEREBYACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY' REGISTERED AND/OR PLUMBING FIXTURES
LICENSED' AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1.AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN,THE ABOVE DES.FRIBgV RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE /
FINAL 4
Val
Lool VALIDA ON ROBERT A. OOD
CK. M.O CASH SUPERVISING MECHANICAL ENG'R
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