HomeMy Public PortalAbout9082 EMPEROR AVE_Plumbing__ 76A667A`(CE 8178)- 11/76
APPLICATION FOR oPLUMBING PERMIT
BUILDING AND SAFETY DIVISION
.FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS IS AW)
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
GAS SYSTEM OUTLETSDISTRICT NO GROUP ZONE RO QED BY
,✓ — —1
OUTLETS OVER
S PER SYSTEM INDUSTRIAL 9L
/J WASTE APPROVAL u
p � INSPECTION RECORD 09
0
a
VI
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant S
APPROVALS DATE INSPECTOR S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING >� Z
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURE
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST QL
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE ESCRIBED RESIDENTIAL
PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK M Q CASH PERMIT VALIDATIO'M cK M O CASH
I 1 9.5 c"AUG u 1 3.5 0 Az1,}
®s
APPLICATION ' OR PLUM ING PERMIT
COUNTY OF LOS ANGELES 4 BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING
NUMBER y FIXTURE OR ITEM O FEE ADDRESS
LOCALITY
WATER CLOSET
NEAREST
BATH TUB CROSS ST Cd �''C
SHOWER OWNER
LAVATORY MAIL
ADDRESS 11-1"
SINK CITY ,,TEL NO
DISHWASHE CONTRACTOR C
CLOTHES WASHER +ADDRESS 3 rAJ 254
r
SWIMMING POOL RECEPTOR IT TEL NO
�G 8e
LAWN SPRINKLER SYSTEM LITATE LIC
CENSE NC��:3'3G CLASS
WATER HEATER
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK n90
5 PER SYSTEM ROUGH PLUMBING ,-19 14 --rl
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES 9
GAS TEST !A
Pian check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ — -
TOTAL FEE �r FINAL
PLAN CHECK VALI DATLQN �
Plan check applicant'
Name
Addres Z - .� IVC _
Gt Z:yTel No Vg
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 6 9 Ci 4 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # a0Doog
REOU IR ED BY LOS ANGELES COUNTY AND STATE OF CA ORNIA OR THAT 1 AM THE 2 O O 0 0
LEGAL OWNER OF AND INTEND TO RESIDE I THEA E DESCRIBED RESIDENTIAL
PROPERTY r'
SIGNATURE v f0 O O 2 a 0 0 U
OF PERM ITTEE
1a01 -79
DISTRICT NO ROCESSED B
INDUSTRIAL
WASTE APPROVAL
� 1
DEPARTMENT OF COUNTY ENGINEER
PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING �j
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS QQ
FOR APPLICANT TO FILL IN LOCALITY �-
BUILDING — l NEAREST
CROSS ST
ADDRESS
i DISTRICT NO GROUP ZONE PERMIT 0
LOCALITYy � 7 47A
NEAREST
CROSS ST RECEIVED BY Ready for Inspection DATE ISSUED
OWNER
MAILs�o � JJ INDUSTRIAL
ADDRESS �/D �� WASTE APPROVAL
CITYp EL NO
INSPECTION RECORD
_Z
PLUMBER �i �_' ���,.�.r.0 ✓
ADDRESB �/J
CITY (/" TEL.NO,/L a.7
LICENSE NO �� ` y Q.000NTti[I STATE ��taAl/�
r 'J
PERMIT FEES a
z
NUMBER TYPE OF FIXTURE OR ITEM FEE
!Q WATER CLOSET(TOILET) @ 08 O
a
BATH TUB @ 080 J--42
SHOWER @ 080
LAVATORY(WASH BASIN) @ 0 80 O
KITCHEN SINK @ 0 80
LAUNDRY TUB OR TRAY @ 0 80 O
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM '1;4'-OUTLETS @ 1 00
WATER HEATER @ 1 00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING PT9l M
GAS PIPING
TOTAL FEE Q
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• GAS VENT r/9a�if'1
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER ✓ ' L
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST F-1 /-I/y
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- n
ER OF THE ABOV/��,lDD SCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED A -/Cu
SIGNATURE
OF PERMIT �..c ? ����- d �4•t' `? FINAL r�I�f! ! I�FJI,'IVI I tllAi�f
76@667 DBS 17 1/63