HomeMy Public PortalAbout4914 ARDEN DR_Plumbing__ 76A667A (CE 817B) -4(77
APPLICATION FOR PLU M B I P RM IT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST. —�
SHOWER OWNER �-��
LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO. 11ed
DISHWASHER �� CONTRACTOR
CLOTHES WASHER
ADDRESS � ,J
SWIMMING POOL RECEPTOR CITY TEL.NO.,�-1 2/
,70
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS DISTRICT NO. UP NE P OCESSE Y
u� �3
OUTLETS OVER I �
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL OG
INSPECTION RECORD
W
�- N
�• -3 D �l U4�/!a C9E'Z�
Plan check fee 0'0 0 a 0yy
PLUMBING PERMIT ISSUING FEE$ r ��#J 32 D'o ''
TOTAL FEE / o o D =
Plan check applicant 091
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
rr/�
City Tel.No. GAS PIPING r ' 1v
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 9
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES _ '1
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA O ATI AM THE GAS TEST
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCR RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE �.
OF PERMITTEE -- FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION <�ml.O. CASH
76 A.667—CE 817 8/68
' APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
C.
FOR APPLICANT TO FILL IN(PR NT OR TYPE) CROSSSST. j,LJ
NUMBER FIXTURE OR ITEM EACH FEE -
Up
WATER CLOSET 1.50 _ OWNER
MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY TEL. NO.
LAVATORY 1.50 dd CONTRACTORK✓�� L`"
SINK 1.50 ADDRESS -
DISHWASHER 1.50 CITY (!�1 TEL. NO.S- 3-o0�U, -
CLOTHES WASHER 1.50 S STATE LIC
LICENSE NO. �+5 CLASS
SWIMNIING POOL RECEPTOR 1.50 DISTRICTN�y 17ZONE I's B.
LAWN SPRINKLER SYSTEM
`
2.00 � J
U o
WATER HEATER 1.50 SU INDUSTRIAL U
WASTE APPROVAL Z
f CD
GAS SYSTEM 5OL'TLETS 1.50 / INSPECTION RECORD v
OUTLETS OVER .30 a
5 PER SYSTEM
I_ Cn
Z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE
APPROVALS DATE IN ECTOR•S 1 ATURE
Plan Check applicant UNDER SLAB WORK
Name 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 �O
PLUMBING.
I HEREBY CERTIFY THAT 1 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 g y
RESIDE IN,THE ABOVE DECCRIYDR.ID IAL PROpERTV. FINAL /SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL ENGOF PERMITTEE '
PERMIT VALIDATION +.o. c ASH
PLAN CHECK VA6PAION CK. .O. CASH