HomeMy Public PortalAbout4918 CLOVERLY AVE_Plumbing__ 76A887 CE#817 5 61
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, SUP T OF BUILDING LOCALITY
L t3
FOR APPLICANT TO FILL IN CRNE ETT L G a i 6-;ip_ Z
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET G �-
MAII.
BATH TUB ADDRESS
SHOWER CITY F TEL NO
LAVATORY
CONTRACTOR - L GU c-
SINK ADDRESS0 v fes,
DISHWASHER CITY TEL NO
TE
LAUNDRY TUB REGISTRATION NO. d'� COUNTY
CLOTHES WASHER DISTRICT (NCO G OUP ZONE P SEED BAY
WATER HEATER
GAS SYSTEM INDUSTRIAL (�
WASTE APPROVAL
INSPECTION RECORD
O
U
W
d
Vf
0 5100 PER ITEM I �/?
OR FIXTURE $ / (/ APPROVALS DATE INSPECTOR 8 SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK-H
TOTAL FEE
ROUGH PLUMBING,-
{
GAS PIPING 9j� /pI ('0 j f0!.P
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST /
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPER UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEEFINAL �� jIQ L,I�ZJyIi/�
AMDATION ROBERT A W OD
CK M O CASH SUPERVISING MECHANICAL ENG R
I' " 6 9 9 0' �N" 1 6 5 D 3 .5 T
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76A887 CE#817 5 61 ,
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDINJOHN G AA E SAFETY DOUNTY NMaISNEORN ADDRESS NG v fP L
WILLIAM A JENSEN, SUP T OF BUILDING .�--
LOCALiTY
FOR APPLICANT TO FILL IN
ROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET bum
BATH TUR ADDRESS
CITY TEL NO
SHOWER
CONTRACTOR C .S 7-A L o 4
LAVATORY
ADDRESS <SINK Qi Liles J
DISHWASHER
TEL NO
STTE
LAUNDRY TUB REGISTRACONTRATION NO. Q COUNTY B
CLOTHES WASHER DISTRICT7NO
G OUP ZONE P SED BY
WATER HEATER
IIVDUSTRIAL O
GAS SYSTEM L7
WASTE APPROVAL
INSPECTION RECORD 0
PE
O $1 DOPER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE-H I ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
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 I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE l
DESCRIBED RESIDENTIAL P UTILITY CO NOTIFIED
SIGNATURE //I
OF PERMITTE FINAL K /P07 deli'
ALIDATION ROBERT A WOOD
CK M O CASH SUPERVISING MECHANICAL ENG R
Lk,3 2 7 5 1 "o hky 17 5 D 3 .5 u t-
g 1 DEPARTMENT OF COUNTY ENGINEER PLUMBING
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES 1
BUILDING f p
WILLIAM J FOX, COUNTY ENGINEER ADDRESS L li
FOR APPLICANT TO FILL IN LOCALITY J
BUILDINGNEAREST
ADDRESS CROSS ST
OCALITY
DISTRICT NO GROUP ZONE PERMIT NO
L
NEAREST
CROSS ST S > //��yR/�ECCEEIV,EDD BY Ready for Inspection DATEISSUED
OWNER i V✓� 6J✓!/6oh—
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
CITY TEL NO INSPECTION RECORD J,
PLUMBER /0 tiCo
ADDRESS • G r _ S �'� ��
CITY TEL NO
O STATE ap
LICENSE NO ❑COUNTY .J
PERMIT FEES a
4LI1BE42 TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET(TOILET) @ 080 $
O
BATHTUB @ 080
SHOWER @ 080
_ t LAVATORY (WASH BASIN) @ 0 BO L/ A
KITCHEN SINK @ 080
LAUNDRY TUB OR TRAY @ 0 80
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM OUTLETS @ 1 00
WATER HEATER @ 100
MISCELLANEOUS
APPROVALS
D AT E INSPEC OR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE d GAS PIPING
IHEREBY ACKNOWLEDGE THAT I HAVE READ TNS A`PPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE ES/nC�RjI�BEID RESIDENTIAL PR ERTY UTILITY CO NOTIFIED
SIGNATURE '�
OF PERMITTEE _ _
FINAL
76A667 DBS 17 1/53