HomeMy Public PortalAbout5616 CLOVERLY AVE_Plumbing__ 617
76A
DBS 12Y54 ,_APPLICATION FOR PLUMBING PERMIT' ,
DBS 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
WM J FOIL, COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN CRI 5T
OWNER L D DISTRICT NO GROUP E READY FOR INSPECTION
MAIL I
MA
ADDRESS Q c.�,�
INDUSTRIAL
CITY / TEL NO WASTE APPROVAL
PLUMBER E/C/f� �- INSP ION REC RD
DTR /
ny"Al
ADDRESS �(� G . '2/ (t �
CITY _
47 LO TEL NO v
LICENSE NO /J � A/ ✓ /7.+- X Ap
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER
_ LAVATORY (WASH BASIN) �� I
KITCHEN SINK F'Q'
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO @ 080 APPROVALS
DATE INSPECTOR S SIGNATURE
GAS SYSTEM---3--OUTLETS @ 1 00
UNDER SLAB WORK F
WATER HEATER @ i 00 ROUGH PLUMBING
PgRMIT S I t OO GAS PIPINGT
TOTAL FEE GAS VENT ' f
/
I HEREBY ACKNOALEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COU TY AND STATE OF _ UTILITY CO NOTIFIED
CALIFORNIA OR THAT 1 AM THE LEGAL OW ER OF THE ABOVE
DESCRIBED RESIDENTIAL OPERTY
� h
SIGNATURE
OF PERMITTEE FINAL
WILLIAM J FOX, COUNTY ENGINEER VALIDATION
-;&1"7 5 1 8 21 3 §.4. 0
BY
` DEPUTY
® � r r
76 A 6r7 — CE 8J7 7-69
APPLICATION FOR PLUMBING PERMIT ;
COUNTY OF LOS_ANGELES o- R
DEPARTMENT OF COUNTY ENGINEER fNEAREST
ILDING
BUILDING AND SAFETY DIVISION DRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN'W JENKINS SUP T OF BUILDING CALITY
FOR APPLICANT TO FILL IN PR NT OR TYPE) OSS ST �C r
NUMBER FIXTURE OR ITEM EACH FEE '
OWNER G QL
WATER CLOSET 150 MAIL,' c_�l,A
BATH TUB �,. 1 50
ADDRESS
SHOWER ' t ' 1 50 CITY'° J�' TEL NO `
LAVATORY 1 50 CONTRACTOR.
SINK r 1 50 ADDRESSq
DISHWASHER 1 50 CPIY L NO 2—
CLIC
LOTHES WASHER 150 STATE // CLASS
LICENSE NO
SWIMMING POOL RECEPTOR 1 50 D,STRI� GROU ZONE OCESSE BY
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER 1 50 INDUSTRIALI
y WASTE APPROVAL ' /CL
GAS SYSTEM c /OUTLETS 150 _ INSPECTION RECORD LJ
OUTLETS OVER
5 PER SYSTEM 30 < Z-
0
' V_
z
Plan check fee 25% of above See reverse
PLUNIBING PERMIT ISSUING FEE $ -2- 00
TOTAL FEE
!e APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING i
000
Address GAS PIPING
GAS VENT `
City ,. Tel No HOT WATER HEATER �d
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES c
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST i
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES OU AND STATE OF t
CALIFORNIA OR THAT I AM THE LEGAL O NE F AND 1 TEND TO ot
RESIDE IN THE ABOVE DESCRIBED REBID TIA OPE r FINAL
t 0
SIGNATURE �i/ JACK R ALLEN, SUP RVISING HANICAL ENG R , S
OF PERMITTEE
PERMIT VALIDATION cK M o CASH o
PLAN CHECK VALIDATION M o ` CA5H
I
a � s..,12 n � L. r. D
r t.
,
DEB
PLUMBING
Loll lVl ■ DYi APPLICATION FOR BING PEIT
BB 17 3 55 >
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles
WM J FOX COUNTY ENGINEER BUILDING
ADDRESS o vrev
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY 12
FOR APPLICANT TO FILL IN NEAREST V
CROSS ST
OWNER ` DISTRICT NO GROUP I ZONE READY FOR INSPECTION
MAIL AID
_ADDRESS �O/< a c
_ INDUSTRIAL
CITY Z TEL NO Z WASTE APPROVAL
PLUMBER //yy�� jfl
.. C ,, INSPECTION RECORD
ADDRESS V ` +
CITY TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) r
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO APPROVALS
DATE INSPECTOR S SIGNATURE
GAS SYSTEM OUTLETS Q 1 00
WATER HEATER Q 1 00 UNDER SLAB WORK
ROUGH PLUMBING
PERMIT 1 00
O GAS PIPING
TOTAL FEE GASVENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNED' OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTI PR PERTY
�
SIGNATURE
OF PERMITTEE j
WILLIAM J FOX COUNTY ENGINEER VALID ATIO R A WOOD, CHIEF PLBG INSPECTOR
180 M
L , QS 5 8 7 .tui 13 3 -