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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LAS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPUCANTTO FILL IN(PRINT OR TYPE BUILDING
NUMBER FIXTURE OR ITEM FEE ADDRESS
WATER CLOSET LOCALITY
BATH TUB N EARESTCROSS ST. dR
SHOWER OWNER O
LAVATORY MAIL,
ADDR
SINK CITY TEL NO.
DISH W ASH ER COIF fT RACTO R t b
CLOTHES WASHER _ ADDRESS
/ SWIMMING POOL OR
to
aTY� TEL NO.
LAWN SPRINKLER SYSTEM STATE ^ UCL
WATER HEATER UCCNSE NO. CLASS Q, 3
GAS SYSTEM OUTLETS D6TRICT NO. P ZONE ED BY
plfT� pygR �� 0
5 PER�SYSffM 1NDUSTRIAL
WASTE APPROVAL v
INSPECTION RECORD u
as
O
Plan check fee
PLUMING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
i
APPROVALSPE
DATE IKSCTOR'S S4QKATURE
Name
IRJDER SLAB WORK
Addreu , ROUGH PLUMBING
6 Tel.No. d GAS PIPING
I HEM By E THAT I HAVE READ TH If APPLICATION AND'STATIE GAS VENT
THAT THE ABOVE IS CORMCT AND AGME TO COMPLY WITH ALL COU KTY ORD IKANCYt
AND STAT[LAWS REGULATING PLUMBING. HOT WATER HEATER
,I H nhy CERTTY THAT I AY PROPERLY REGMT'EMD AND/OR LICLPMED AS PLUMBING FIXTURES
REOLIMM BY LOS AXGELCS COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF,AND DrrEND TO RESIDE N THE ABOVE.DESCRIM RISMENTIAL
PROP am. UTILITY CO.NOTIFIED
SIGNATURE
OF P Ei RM MYTH FINAL
PLAN CHECK VALIDATION Cx r.o. CASH PEVIT VtID&TION �}L � CASH
1 fi 3 -r t1
� � �i � q4-j �,
7dMV�.NJo1I M
r -
� APPLICATION FOR PLUMBING PERMIT,
CO;
TT OF LOS Allfcwl.FS
DEPAHaCiT OF COUNTT ENGUEM
BUILDING AND SAFETT DIVISION
$N A. Kw3 f'�� aDD
CTAMATP D. GRUFnc 9.0 -f vmv
C
FOR APPLICANT TO FIT.L IN M O
NUI B FIXTURE OR IT'E}d
owmm
VIaTEH CLOS KAM
r BATE TUB DAD REE
CIT! ffi. NO.
LAVATORY comm&cMNTANA PLUMBING CONTRACTORS
Im ADD a» 1332q'12- Ector Street
Dtaawalst� car of I ftwAo. ED. 7-7226
LAUNDRY TUB I�ISTHATION N* "" COUNTY Fl
CL07M W AMMD 46fR1 CTT P P ED BY
WATER BSATF� Jml Lr( I
Qu BTQmI UEDUSTSIAL
WAM APPROYEL
nUWE=ON RMORD
J
APPROV6LAI DATE IHdPECrOfI'B SIQIiATURE
PERMIT i Z 00 UNDER WORK
TOTAL FEE ROUGH PL UHHING
OAS PIPING
I MIJERY ACCKNOWLIOGI TQAT 1 HAV[ RIAD THIS APPLICATIOM
AND STATI THAT THE= 19 CORRICT AND AGM TO COMPLY GAS VENT
WITH ALL COUNTY ORbIlANCX8 AND STATI LA" RIQULATINti HOT WATER DATER
PLUMBING.
I FAQ« CIYTIFT THAT I All PROPMT IIIf1/T�lm /�ID/OR PLUMBING FIXTURED
L]CULM AI RIAUIRJm IST LOS AIQILIS CDOIITY AND 1TATI OF GAS•I.ES.I•
CALIFO"LA OR 7RAT t AN THI 1.IUL O7NiQ OF THI ABOYE
D1ISCEUBlm RIMS ROPIIITT. UTILITY On.NOTIFIED
SIGNATURE • _
OF PE" FINAL
Or AI.mATION ROBERT A.WOOD,
■.0. CAM SUPERVISING MECHANICAL ENd'R
Wo 1 66818 JUN 2 5 D 1 3 .0 0
DW0,17 APPLICATION FOR PLUMB,IJV T 1
ou.+T'D�QN OF BUILDING AND SAFI�rY
' Dnaltmt
x+iwmTt of f ovzwkb hiwr
r r A ,BUILDING
v JOHN A. LAMBIE, COUNTY ENGINk( w
/ �DRR9a
CAFBATT D,GRIFFIN,SUPT OF BUI
LOCAI 1 TY
FOR APP=ANT NM&REBT
CRO as ST.
OWNER
DIBTRICT GROUP ZON! aLT ion �XllrRCTIOX
INDUSTRIAL
C N WASTE APPROVAL�pp��
PLuwe f+�4+r+,^�+•ON RWOED
ADD
CITY /�
LICENIr!NO. d 7 V 6
NUY•tA TYTt OF FIXTURt OR I7b1 Ftt
WATER CLOSET (TOILET) @ 1.00
BATH TUP 101.0-0
allow-KR 1.00
LAVATORY C AFH BASIN) $1.00
KITCHEN FINK 41.0.0
D IA HWAsti[R 411-o-0
LAUN TUTS OR TRAY 01.0.0
C Its WAIIHER 11.00
WATER HEA 1.00
GAB FYSTYM gri.clo
i
APPHOVAI$
DATE 1N15PECTOH'8 819NATUBE
Ut DIER SLAB WORK
PERMIT ; 00 UGH PLU GING
GAS PIPING
TOTAL. FEE G VENT.
I HERBY ACKNOVILEDGE ?HAT 1 11AVE READ THIS APPLICATION HOT TER HEAT
A'11D STAVE TKAT THE ABOVE 18 'CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AXP STATE LAWS REGULATIRG
PLUMBING. PLUMBING FUTURES
1 HEREBT CERTIFY THAT 1 AM PROPERLY REGISTERED ARD/QR. GAS TEAT
LICENSY AND TE OF
CALIFOED AS REQUIRED BY LOE ANGELES COUNTIA OR THAT I AM T E LEGAL OF ABOVE UTILITY CO.NOTIP'IED-
DESG$IBED RESIDENTIAL. P .
SIGNATURE
OF PERMITTEE. FINAL
JOHN A. L.AMERIE, COUNTY ENGIN¢ER 7ATION ROBERT A.WOOD. CHIlF PLBQ. INSPECTOR
68D-, NOV 20 3 2.00 9