HomeMy Public PortalAbout10615 DAINES DR_Plumbing__ _TBA66T -CE R61T 9/63
APPLICATION FOR `PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER. BuamNc / t
BUILDING AND SAFETY DMSION ADDESS E J
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A'. JENSEN, SUPT OF BUILDING '
" LOCALITY CiT
FOR APPLICANT TO FILL IN NEAREST // ,
CROSS ST. / IIQ
.NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSES $1.25 MAIL -
RATH TUB 1,25 ADDRESS
SHOWER 1.25 . CITY TEL. NO.
LAVATORY LYS ME
CONTRACTOR .:.,$ ? 1n-7-
SINE 1.25' ADDRESS �5 �j, '2�(! c,-t
DISHWASHER - 1.2S g-s- CITY CTOR'S ) TEL. NO.y 3"6)� dam.
LAUNDRY TUB 1.25 REGCONI
STRATION AAT ON NO. ( � 7 '/ COUNTY STATE STATE 0
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P CEBBEDBY
WATER HEATER 1.50 Q
Y
WAJ
GAS SYSTEM-OUTLETS-- 1'50 INDUSTRIAL o_
WASTE APPROVAL O
OUTLETS OVER 5PER SYSTEM .30 INSPECTION RECORD V
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT 5 ]ANDJOR
0 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE .. N'� GAS PIPING
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIIONAND STATE THAT THE ABOVE IS CORRECT AND AGREPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWING HOT WATER HEATERPLUMBING.1 HEREBY CERTIFY THAT I AM PROPERLY REGIST /OR PLUMBING FIXTURES
LICENSED Ai REQUIRED BY LOS ANGELES COUNTY OFCALIFORNIA-OR THAT I"AM THE LEGAL.OWNER AF+ATO's GAS TESTRESIDE IN.TME ABOVE iCR ED RESIDENTIAI.PROP AUTILITY CO. NOTIFIED '
SIGNATURE
OF PERMITTEE IV
VFINAL J
LIDATION ROBERT A. WOOD
cn. m:o. CASH SUPERVISING MECHANICAL ENG'R
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76A64 I APPLICATION OR PERMI
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COUNTY OF LOS ANGELES I SEWER—SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUIDING d
JOHN A. LAMBIE. County Engineer ...L. s
WILLIAM A. JENSEN, Sup't of Building S
LOCAL TTY
NEAREST
FOR APPLICANT ] FIL /IN CRO SS
ST
LEGAL J n
DESCRIPTION LOTNO. OWNER
MAIL
BLOCK TRACT ADDR£$$
NO: OF BLDG.
SIZE OF LOT NOW ON LOT CITY TEL. NO,
USE OF DISTRICT NO. GROUP MAP PR CESSEO BY
MREGISTRATIONNO.
BK PG/�
�l' rJ Q 5
�[ CONNECTION.DATA
B gTION
TEL. NO. 00.3
❑ STATE MANHOLE REFERENCE UPPER
� ❑ COUNTY
NO. DESCRIPTION OF WORK FEE - TYPE OF CON EC LENGTH FROM !{
HOUSE SEWER CONNECTING TO Y..Y. C 6/ P.�. ,M.L.TO P.L.
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PUBLIC SEWER �' $5.00 �J I.C.NO, d
BEPTICTANK.SEEPAGE PIT OR O
PITS ANO/OR GRAINFIELD 510.00 CO.IMP. NO. JOB NO.
HOUSE SEWER CONNECTING TO V
TRUNK PERMIT NO. ROAD PERMIT
PRIVATE DISPOSAL SYSTEM 53.00 C
CONNECT ADDITIONAL BLDG.OR gFFIDq VIT wgVu IK[NL RECORD.INSTR.N DATE / - O
WORK TO HOUSE SEWER ® 53.00 V
OVERFLOW SEEPAGE PIT.GRAINFIELD W
E%TN„CESSPOOL.DRYWELL.MANH O LEE.@ $5.00 IL
MWT.OR ST.WI D SING
ALTER.REPAIR OR ABANDON HOUSE N
SEWER OR DISPOSAL SYSTEM ® 53.00 STATE ENCR MENT
iPERMIT NO. p'/ O
INDUSTRIAL
WASTE APPROVAL
CHARGES
OWNERS PERMIT s z o0
CONNECTION CHARGE FEE
AUTHORIZATION I TOTAL FEE
'I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON/ REIMBURSEMENT FEE
TRACTOR TO CONNECT THE ABOVE DESCRIBED'EXISTING DWELLING
TO THE PUBLIC SEWER, APPROVALS DATE INSPECTOR5 SIGNATURE
SIGNED THISDA F ]9_
OWNER OR ee� NEW HOUSE SEWER
OWNERS AGENT CONNECT ADDITIONAL
BUILDING OR WORK
ADDRESS
SEPTIC TANK.SEEP,PIT(B)
I HEREBY ACKNOWLEDGE.THAT 1 HAVE..READ THIS APPLICATION ANO/OR GRAINFIELD”
AND-STATE THAT THE ABOVE IS CORRECT AND gGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR ALTER.REPAIR,SEWER OR
LICENSED AS REQUIRED BY LOS,ANGLES COUNTY AND. STATE OF SEWAGE D ISPOSA L SYSTEM
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,'AND INTEND TO DISCONNECT PLUG AND.
RESIDE IN, THE ABO DESCRIBED RESIDENTIAL PROPERTY gBANDON HOU.E SEW ER
.IGNATURE BACKFILL SEPTIC TANKS LIOF PERMITTEE SEEP, PITS) ❑ CESSPOOLS El
CK.
VALIDATION ROBERT A. WOOD
O. CASH
SUPERVISING MECHANICAL ENGINEER
. . M.
81' 2 `66 FEB 1 1 Q D 7.00' < .
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY EN---.---
BUILDING
BUILDING AND SAFETY DIVISION ADDRESS �O /! �CLlii2Co i
JOHN A'. LAM BI E. COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY b
FOR APPLICANT TO FILL IN NEAREST / -
CROSS ST.
NU MEER FIXTURE OR ITEM EACH "FEE'
-0WNER
WATER CLOSET SI.25 MAIL
BATH TUB 1.25 ADDRESS - 1
SHOWER .1.25 CITY SEG..NO.
LAVATORY 1.25 CONTRACTO
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.,W �Q
LAUNDRY TUB 145 "CONTRACTOR'S STATE
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP Z N PROCESSED BY,
WATER HEATER 1.50 Sa i
L5U INDUSTRIAL y
CAS SYSTEM OUTLETS WASTE APPROVAL Q
OUTLETS OVER 5-PER SYSTEM .SO INSPECTION RECORD U
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2-3
-GS - 40 j"� a-� u".r ai/,cam,,, o
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2 LQ z
APPROVALS DATE C� INSPECTOR'S SIGNATURE ,
' PERMIT S p pp UNDER SLABWORK
ROUGH PLUM BIN �� •6�
TOTAL FEE
GAS PIPING
I HEREBY ACKNOWLEDGETHEABOVE
IS 1 HAVE REAAND 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 p
PLUMBING. '
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY.LOB..ANGELES-COUNTY AN.-STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,ANO INTEND TO _
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED / ,1
SIGNATURE
OF PERMITTEE
FINAL -
ALIDATION ROBERT A. WOOD
cN. M-0. .CASH SUPERVISING MECHANICAL NG'R
L 8 :14 3G FEB 2 5 D 15.00-
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