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76 A 667—CF 17 8/68
APPLICATION FORPLUMBING PER T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIBUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 17
4137NO.
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY LFOR APPLICANT TO FILL IN (PR NT OR TYPE) NEARESTC OSSST. L itJNUMBER FIXTURE OR ITEM EACH FEEWATER CLOSET 1.50 OWNERTT I
MIjIILBATH TUB 1.50 WARRESS t� 3 C1-SHOWER 1.50 CiIIY 7' j�G-Y� G ITLAVATORY 1.50 CmNTRACTOR S /°pSINK 1.50 'DREGSC7. yVj�DISHWASHER1.50CITYrC-A , A 7--CLOTHES WASHER 1.50 SPATE r LICENSE NO. 'LS
SWIMMING POOL RECEPTOR 1..50
DISTRICT 140. GRO ZONE ZRO L. 9-
LAWN SPRINKLER SYSTEM 2,00Aft�1
(� C>
WATER HEATER 1.50 INDUSTRIAL U
ASTE APPROVAL Z
GAS SYSTEM OUTLETS 1.50 FINSPECTION R COAD -
OUTLETS OVER11
5 PER SYSTEM •30 y Lu
a_
z
Plan check fee 2S% of above. See reverse. _ L
PLUMBING PERMIT ISSUING FEE 9 2 00
TOTAL FEE
- O APPROVALS DATE INSPECTOR'S SIGNATURE
i Plan check applicant UNDER SLAB WORK
Name .ROUGH PLUMBING
j Address GAS PIPING
(�A5 VENT
City Tel. No.
HOT WATER HEATER
I 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 LATING 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 LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE; JACK R. ALLEN, SU ERVISING MECHANICAL 'R.
PERMIT VALIDATION CK. M.0. CAS
j PLAN CHECK VALIDATION CK. M.O. CASH
i
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Ag
76A687 . �CA !,s. FO xw S k' NG PERMIT
d6 8.1"J t3 =F
Departrnex+ of County 'ngir'Per, "I W MOVIE
C`ouig at_Laa Fn �k�s ���ra�
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DES617
76A10 APPLICATION FOR PLUMBING PERMIT .�
DBS 17 SS
DN ISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING
"? t��—"'
JOHN A LAMBIE COUNTY ENGINEER DDRESS aJ L rl� 77
CASSATT D GRIFFIN,SUP T OF BUILDING
LITY ,fry
F R APPLICANT TO FILL IN NEAREST
CROSS ST
OWNER DISTRICT NO GROUP ZONE READY FOR INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY TEL NO f? WASTE APPROVAL
PLUMBER j �,,/,(�7� INSPECTION RECORD
ADDRESSti:? T
Y I
CITY � � EL NO h
VALICENSE NO I �7 �-\ fT'L♦C Y C�q'��l-�t., (~
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $100 $ U �Y'y7� O-t)gy
BATH TUB @ $1 00
SHOWER @ $1 00
LAVATORY (WASHBASIN) @ $1 00
KITCHEN SINK @ $1 00
�)
DISHWASHER @ $1 00 Laj-- 1�
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $1 00
WATER HEATER @ $100
GAS SYSTEM @ $1 00
APPROVALS
DZkTE
^� INSPECTOR(5 SIGNATURE
UNDER SLAB WORK
PERMIT $' 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE .5 �� GAS VENT
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
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 I THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED '� AA
DESCRIBED RESIDENTIAL PE
/
SIGNATURE aJ
OF PERM ITTE FINAL p
JOHN A LAMBIE COUNTY ENGINEER VALIDATIO ROBERT A WOOD CHIEF PLBG INSPECTOR
CK N O CASH
[moi 4 5 4 5 JAN 2 8 3 500 to