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APPLICATION FOR PLUMBING PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS J J �(j
WILLIAM A. JENSEN. SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
4 CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS 41-2-6- crr-
DISHWASHER 1.25 CITY TEL. NO. 3-o07'
CONTRACTOR'S J STATE Q"
LAUNDRY TUB 1.25
REGISTRATION NO. 07 I rJ COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT o G Zo E PIEO -0 BY
WATER HEATER 1.50
GAS SYSTEMOUTLETS 1.50 (l INDUSTRIAL d
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
OC
O
r
V
W
N
-- Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
? t J ROUGH PLUMBING
TOTAL FEE ,7 o GAS PIPING
I HEREBY ACKNOWLEDGE 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.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABO D RESIDE IAL PROPERTY. UTILITY CO. NOTIFIED
11
SIGNATURE N_
OF PERMITTEE V DE IBE ✓�•
FINAL
0 LIDATION ROBERT A. WOOD
CK. M.0. CASH SUPERVISING MECHANICAL ENG'R
L�ILO 0 7 1 6"1'43 SEP 2 6 5 0 3.50-
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• APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING �� _
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN. SUPT OF BUILDING
LOCALITY EP� Gol
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
MAIL �� n �L
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY ,4 1 T TEL. NO.
LAVATORY 1.25 CONTRACTOR .9Re S Alm' ;
SINK 1.25 ADDRESS Q fit/
DISHWASHER 1.25 CITY L TEL. NO.N f/4'
LAUNDRY TUB 1.25 CONTRACTOR'S �„ STATE F]REGISTRATION NO. Y
COUNTEJ
CLOTHES WASHER 1.25 DISTRI C�' N�. - GROU ZONE_ PRO rB
ES D Y
WATER HEATER 1.50 _� (,/ U[•�
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD CL
jw0
Lm
Ln
APPROVALS DATE INSPECTORS SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE - GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A LIGATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I 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 I AM THE LEGAL OWNER ,AND INTEND TO
RESIDE IN, THE A VE DESCRIBED RESID NTIA �R PERTY. UTILITY C . NOTIFIED
SIGNATUREjL, i'Z'L•`� !2 '
OF PERMI
FINAL
C j' iLIDATION ROBERT A. WOOD
M.O. CASH SUPERVISING MECHANICAL ENG'R
0 3 4 2Q SEP18 5 0 4.75-
COUNTY OF LOS ANGELES1 APPLICATION FOR PERMIT
'Department of County Engineer _ am
DIVISION OF BUILDING & SAFETY PL� ts ' N 1
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN D{ NO. GROUP
P ZONE PER
MIT NO.
PLUMBER RECEI ED BY READY FOR DATE ISSUED
r
ADDRESS - r W FIRST INSPECTION /�/��
J � BUILDING
CITY ,)1624 /Vii` TEL NO. ��IfY% ADDRESS
COUNTY /ya LOCALITY
LICENSE NO. G EXPIRES
NEAREST
PERMIT FEES CROSS ST. /D �p
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER .f,/ ale"iba(� Com'
MAIL
_Z WATER CLOSET(TOILET) @ 0.50 $ ADDRESS
BATH TUB @ 0.50 CITY TEL. NO.
9 SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
Eve LAVATORY (WASH BASIN) @ 0.50 �j a APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS— Q 0.50 �- �2D
SIGNATURE 13.50OF�
WATER HEATER @ .5❑ PERMITTEE / f
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK @ 0.50 �� �`��
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50 7e rl4
DRINKING FOUNTAIN @ 0.50
URINAL 0.50
Q
HOUSE SEWER @ 0.50 ?
t7
MISCELLANEOUS
O
APPROVALS
DATE INSPEC R'S NAME
ROUGH PLUMBING J�
GAS PIPING
GAS VENT V
CESSPOOL @ 7,00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT 7.00 GAS TEST � _
UTILITY CO. NOTIFIED Al .1I! w 5'
TOTAL FEE
P.1$�® ® IYo' v
FINAL 7"
76A667 DBS#*17 6-52 r