HomeMy Public PortalAbout9023 BROADWAY_Plumbing__ 7eAO67 APPLICATION FOR PLUMBING PERMIT
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DIVISION OF BUILDING AND SAFETY 1
Deportment of County Engineer _ .. - .. .
County of Los Angeles I BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADORES.
CASSATT D. GRIFFIN, SUr'T OF BUILDING �r P /
, . - LOCALITY/ll_ _C�-
__ FOR APPLICANT TO FIIL IN I NEAREST ^C -
CROSS ST. LV
OWNER /� - /J- A7 DISTRICT NO. GROUP READY FOR INSPECTION
MAIL
ADDRESS % 6)"Z-3 �-1[7TJ/IJ�/�Lu �J D�
INDUSTRIAL
EL.
CITY _ CI
EL. NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
i ,
CITY TEL. NO.
LICENSE NO.
NUMBER TYPE OF 51XTUBE OR ITEM. FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00 ( "
SHOWER @ $1.00
LAVATORY (WASH BASIN) @' $1.00
KITCHEN SINK @ $1.00 0�
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY .@ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ 51.00
GAS SYSTEM @ $1.00
APPROVALS '
DATE INSPECTOR'S SIGNATURE
^ UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
^ GAS PIPING
TOTAL FEE dV
GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM. THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
r
SIGNATURE ����- /
OF PERMITTEE, •�-Q=��'//' .I,C.G - � FINAL
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATIO ROBERTA. WOOD, CHIEF PLBG. INSPECTOR
CK. (" 9 -„" zR Aus30 3 3.0 0 �.
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76APD7-CE817 10-60
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMSIE, COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEA ECRS ST. F
WD
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET'
MAIL
BATH TUB ADDRESS D
TEL. NO.
SHOWER
LAVATORY CONTRACTOR
SINE ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S
LAUNDRY TUB REGISTRATION NO. CosjT Tom^(
CLOTHES WASHER - DISTRICT NO. GROUP ; Z5)AIE P CE88ED BY
1 WATER HEATER %
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL - }
1 INSPECTION RECORD // /f Q
G /(I /G 3 /ii/i r, yi% / v
GAUJIN
• Z
® $1.00 PER ITEM
OR FIXTURE APPROVALS \DAT INSPECTORS ilUNATURE
PERMIT $ 2 00 UNDER SLAB WORK , N^ I1^ n. /11/1.
TOTAL FEE- ROUGH PLUMBING �0 11 Y V 4A 1AV/
GAS PIPING 1 4 r
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
D , V
ANSTATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE GAS TEST
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
U,
SIGNATURE ^1 (� I/f/
OF PERMITTE FINAL 1_ (l I \I l� Y 11 I��
VALIDATIOROSERT A. WOOD
cK. M.o. GASH SUPERVISING MECHANICAL ENG'R
LACO2:1I I JM25 5 A 3.25- n
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]6A66]-CE#SIT 5�61
APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION [ADDRESS
ILDING n p
JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING
CALTTY- _FOR APPLICANT TO FELL IN EARESTROSS S7.NUMBER FIXTURE OR ITEMWNER -
2-WATER CLOSET MAI. i
HATH TUB ,
ADDRESS 9
CITY _ NO-z -2„sr^ f
SHOWER
LAVATORY
CONTRACTOR
ADDRESS
SINE
DISHWASHER CITY TEL. NO.
CONTRACTOR'S S7A ❑
LAUNDRY TDB J REGISTRATION NO. COUNTY
CLOTHES WASHER _ �`7 OISTRICT NO. OR 20 E PR E Y
WATER HEATER _ ��( .�J D - d
GAS SYSTEMINDUSTRIAL 0
'5
' APPROVAL / / V
INSPECTION'RECORD., !i
�6"Z--�//Y,�'iLc-7i=��y'�•<s/9 /moi ��
® $1.00`PER ITEMLIQ ols -.2 l 1eN �Y
OR FIXTURE S OAPPROVALS DATE INSPECTOR•BEIGNATURE
PERMIT S 2 00 UNDER SLAB WORK II 1 I
TOTAL FEE �-D ROUGH PLUMBING "l Y/l J1.2�A/� hV/
GAS PIPING -
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APFLICATION
D - I J
ANSTATE 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 A
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED I II'.M1
SIGNATURE 1 I I ll I
OF PERMITTE
FINAL
VALIDATION ROBERT A"w6ob�'
CK. M.0. 6n-1)
ASH SUPERVISINGIMECHANICAL ENG'R
LACO 1 7 3 310 JUL 17 5 D 7.50-
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