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76 A 54 817 8/68
APPLICATION FOR PLUMBeGP.ERMI
• COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
tai/7^!
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST c
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRESS I'
SHOWER 1.50 CITY rV, TEL. NO.
LAVATORY 1.50 CONTRACTOR (�
SINK 1.50 ADDRESS. 7AIr r
DISHWASHER 1.50 CITY ' D'7-71'010W TEL. NO.
CLOTHES WASHER 1.50 STATE C
LICENSE NO. aC CLASS s�._�,(j
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO GROUP ZONE RE BY a
LAWN SPRINKLER SYSTEM 2.00 —5� V
WATER HEATER 1.50 INDUSTRIAL o
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
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OUTLETS OVER �
5 PER SYSTEM _ .30 Z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
'POT.4L
FEE
APPROVALS jDA7E I ECTOR'S GN TURE
Plan check applicant UNDER SLAB WORK .�
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I 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
PLUMBING.
I HEREBY•CERTIFY 1 AM PROPERLY REGISTERED ANWOR UTILITY CO. NOTIFIED _
LICENSED AS REQUIRE BY 05 ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I M E LEGAL OWNER OF,AND NTEND TO
RESIDE IN,THE ABOV BED RESIDENTIAL PRO FINAL
SIGNATURE JACK R. ALLEN, SUPERVISIN ANICAL EN G'R.
OF PERMITTE
PERMIT VALIDATION CK, M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
C�
4
CE 1!317IREV.6/78) C
APPLICATION F LUM PERMIT
L�JCOUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS
NUMBER FIXTURE OR ITEM @ FEE
� WATER CLOSET LOCALITY
NEAREST �r-
BATH TUB CROSS ST..
SHOWER OWNER e'1'4'?-g'o
MAIL
LAVATORY ADDRESS ��11-7�-
SINK CITY TEL.NO. 2-Y 7171 Z
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS a rC.4
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM
STATE LIC,
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
AS PIPING 0
O
GAS VENT V
HOT WATER HEATER C
F�
PLUMBING FIXTURES U
GAS TEST d
Plan check fee UTILITY CO.NOTIFIED Z
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant _ _ PLAN CHECK VALIDATION
Name
Address
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE :2 8 84,7 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES '
AND STATE LAWS REGULATING PLUMBING, PERMIT VALIDATION e + e * 5
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGE UNTY-AND STATE OF CALIFORNIA OR THAT I AM THE 2 r '� q 00
LEGAL OWNER OF.A INTEN TO RESIDE IN THEA E DE IBED RESIDENTIAL .n
PROPERTY. 0
SIGNATURE
OF PERMITIlhI3 pw 0204—80
r CT�o.� P o E��
INDUSTRIAL
WASTE APPROVAL
e N. .\__
76 P:G7—CEL 817 8/68
• APPLICATION FOR PLUMBING PER T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING Q -
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ,C
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT ONEARESTR TYPE) CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNERt w/ p
.�^
MAIL
BATH TUB 1.50 ADDRESS -
SHOWER 1.50 CITY - - TEL. NO.
LAVATORY 1.50 CONTRACTOR V4,�4
SINK 1.50 ADDRESS IV,,
/
DISHWASHER 1.50 CITY
CLOTHES WASHER 1.50 STATE
LICENSE NO. � 7U UVCLASS _ 37
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GRO P ZONE P SS BY
LAWN SPRINKLER SYSTEM 2.00 r O .� r•
`tom CD
-WATER HEATER 1.50 INDUSTRIAL U
WASTE APPROVAL Z
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD 0
OUTLETS OVER
5-PER SYSTEM •30 a
N
Z
Plan check fee 25 of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING.
GAS VENT I
City Tel. No. HOT WATER HEATER
LANSTATE
REBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
NG.
REBY CERTIFY T T I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
ED AS REDUI D LOS ANGELES COUNTY AND STATE OFRNIA OR THAT A THE LEGAL OWNER F,AND I TEND TO IN,THE ABO RIBED RESIDENT L RO PE RT V. FINAL
TURE JACK R. ALLEN, SUPERVISICc
CH ANIC AL EN G'R. .
ERMI EE
PERMIT VALIDATION M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
r , . 3 3 .5 jrui214 5 0 3,5 0