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HomeMy Public PortalAbout9814 BROADWAY_Plumbing__ 76 A 667—CE 817 468 V� .7 ' I APPLICATION FOR PLUMBI G PER IT COUNTY OF LOS ANGELES p. /J�� A DEPARTMENT D COUNTY ENGINEER ADDRESS / (I 6,401f �f/ �R BUILDING AND SAFETY DIVISION RUILDIN JOHN A. LAM BI E. COUNTY ENGINEER COLEMAN W. JENK(NS. SUPT. OF BUILDING LOCALITY A1-) ?4s e, ITY FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST /j D �, p CROSS ST. OJY b7 NUMBER FIXTURE OR ITEM EACH FEE O ^ 0 0 e OWNER GY/L y' p. WATER CLOSET 1.50 ` ,�55 1� BATH TUB 1.50 1 (� ADDRESS ti GP7 ,[J tl� ff y SHOWER 1.50 I w CITY t Co / TEL. NO. f{ LAVATORY 1.50 CONTRACTOR ® 400,A' Ai R RA SINK 1.50S Q ADDRESS DISHWASHER 1.50 CITY TEL. NO. CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS ti SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GR�O/Uy NE CE Br LAWN SPRINKLER SYSTEM 2.00 AY / d O WATER HEATER 1.50 INDUSTRIAL u _ WASTE APPROVAL GAS SYST EM1f OUTLETS 1.50 � 5 � INSPECTION RECORD(i ZO OUTLETS OVER 30 ¢ G 5 PER SYSTEM W a N Z Plan check fee 25 of above. See reverse. PLUMBING PERMIT ISSIJING FEE S 2 00 TOTAL FEE APPROVALS DATE INSP TOR'$$IGNATURE Plan Check applicant UNDER SLAB WORK , Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER 1 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 ' PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AN /OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALI TORN IA OR THAT I AM THE LEGAL OWNER OF,ANO INTEND TO RESIDE IN,THE ABOVE 'qDESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE l:Ill p�P1421L/ I JACK R. ALLEN, suPERVISIN CHANICAL ENG'R. OF PERMITTEE 444 Bo M v� •T/ PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION cK. M.o. ASH U , 9 3 1 1-� APR 11 5 D 1 1 .00- v 76A667 ICE-617) 1/75 ,�-11 4 �� C APPLICATION F�IbR PL64BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS `/ ' 7•'?n-a*- �y HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY I FOR APPLICANT TO FILL IN (PRINT OR TY PEINEAREST CEASET. 1 NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 2.00 OWNERG✓7 /LA'7 MAIL BATH TUB 2.00 ADDRESS SHOWER 2.00 CITY TEL. NO. Z.Fz , 7!�1,7 LAVATORY 2.00 CONTRACTOR ,.©(� SINK 2.00 ADDRESS DISHWASHER 2.00 CITY 77�G.4-7��ia TEL. N077� CLOTHES WASHER 2.00 STATE LIC f LICENSE NO. �� f�f7 CLASS (— SWIMMING POOL RECEPTOR 2.00 DIS ICT NO.GROUP NE PF ESSED BV LAWN SPRINKLER SYSTEM 2.00 .,.l4//��'`' Pi WATER HEATER 2.00 INDUSTRIAL ' WASTE APPROVAL y GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD U OUTLETS OVER [C 5 PER SYSTEM .30 p F U W 0. N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE ' APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check applicant A UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City ', Tel. No. GAS VENT 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 THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED _ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEG_IYQV{iIER OF, AN INTEND TO RESIDE IN THE ABOVE DES_CRIHSVRESTDDNTIAL PROPERTY. FINAL �'a.��' ./tip SIGNATU RE .+i_'4_` ___� _ OF PERMITTEE .... PERMIT VALIDATIONCN. .0: CASH ' PLAN CHECK VALIDATION CK. M.D. .CASH 0 .0'9-JUi+ 25 /5-0 4.7 5 Au3 76AG67C ICE-01]13) -9/l5 (fe V APPLICATION FOR PLUMBING PERMIT {� BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPEI BUILDING 9 q NUMBER FIXTURE OR ITEM C FEE ADDRESS WATER CLOSET D LOCALITY BATH TUBNEAREDS T 1 CROS$ ST. Lr/ SHOWER OWNER 1 LAVATORY MAIL ADDRESS SINK CITY TEL. NO. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL. NO. LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO. CLASS CIL. GAS SYSTEM OUTLETS DISTRICT NO. GROUP ZONE OC D BV O ✓ CJ OUTLETS OVER V 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL yVj d INSPECTION RECORD ? Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE Plan check applicant Name APPROVALS DATE Ius PEc ro R's situ AruRc , UNDER SLAB WORK Address ROUGH PLUMBING City Tel. No. 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 AND/OR PLUMBING FIXTURES LICENSE DAS 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 ABOVE DE CRIBED RESIDENTIAL PROPERTY, UTILITY SO. NOTIFIED SIGNATURE OP PERMITTEE K� FINAL b-16 7 / PLAN CHECK VALIDATION CK. M.D. cnsH ' PERMIT VALIDATION CK. M,O. cases P.PR 18 5 D 1 3.5 O.A-s