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•' ,,.� APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES '
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ABUILDING
DDRESS ,� / d �d �%V C l/i�1(/�
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY C� T
FOR APPLICANT TO FILL IN NEAT ,� d ,a d w ►�•
CROSS ST f�^�
NUMBER FIXTURE OR ITEM EACH FEE f 'd s
OWNER 1✓ r� 0
WATER CLOSET $125 MAIL
BATH TUB 125 ADDRESS
SHOWER 125 CITY TEL NO
..3
LAVATORY 125 CONTRACTOR WqJ��OS
SINK 125 ADDRESS 3 '((:) ( 041VE
DISHWASHER 1 25 CITY 1 14 TEL NO ..3Oe a
LAUNDRY TUB 1 25 CONTRACTORS STATE El
JS REGISTRATION NO COUNTY ❑
f CLOTHES WASHER 1 25 DISTRICT NO GROUP E ED BY
WATER HEATER 1 50 P SE�i ( ,�J
GAS SYSTEM OUTLETS 150 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION
/RECORD
�f �/'� a
IS
J �
z
UAP E INSPECTOR S SIGNATURE
PERMIT $ 2 CC UNDER WORK
ROUGH PL
UMBING ��
TOTAL FEE 1''
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER ' �X �„v�r✓`,
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES,,-'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST I�
CALIFORNIA OR THAT I AM THE LEGAL-OWNER OF,AND INTEND TO f _{
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED V �
SIGNATURE
OF PERMIT
TE '
FINAL
LIDATION ROBERT A WOOD
cK M J . CASH SUPERVISING MECHANICAL ENG R
s
D B S-17 25M SETS 6-46 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY
PLUMBING' � COUNTY OF LOS ANGELES
WM.J. FOX.CHIEF ENGINEER
NATURE OF INST-A-=Tl[5N DISTRICTNO GROUPI- ZONE PgRRMII`
ROUGH FIXTURES COMPLETE S `fes �/ ( ! ✓
HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
AS- MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
NAME M. Ca NOTTINGHAM C JOB
ADDRESS 3 � .�o A
m OF TEMPLE CITY ro-�
� ADDRESS LOCALITY123 N. CIZOVERLY tio
d
CITY TEMPE CT4�YI lg'J l CROST
-CROSSST.
Lr.
COUNTY
CERT No EXPIRES m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL 2 MAIL
ADDRESS /).yd..
NORTH O
CITY TEL No
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION
/
/it L. Yl_F`16�A w,:P•a ,
PLUMBER
1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
M>
._ OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK i
BATH TUB FURNACE 3
ROWER DISHWASHER O
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP BINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'!NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAB SODA FOUNTAIN
OUn GAS PIPING
GAS VENT I I
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
�CESSPOOI SEPTIC TANK SEWER I ?
S aJ� UTILITY CO NOTIFIED
TOTAL FEE / V
�� I FINAL
76A667•CE0817 5/63
o
APPLICATION FOR PLUMBING PERMI
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 f
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $125 MAIL
cy
BATH TUB 1 25 ADDRESS
SHOWER125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINS 1 25 ADDRESS
DISHWASHER 125 CITY TEL NO
LAUNDRY TUB 1 ZS CONTRACTOR S STATE ❑
REGISTRATION NO COUNTY ElCLOTHES WASHER 125 DISTRICT N NE P O S D Y
WATER HEATER 1 50
GAS SYSTEMOUTLETS 150 1 CL
WDUSTRIPASTE PAOVAL 0
OUTLETS OVER 5 PER SYSTEM s0 INSPECTION RECORD V
DC
0
CLFU-
a
N
Z
APPROVALS A0ATEj INSPECTOR S SIGN,.TURE
PERMIT $ 2 00 UNDER SLAB WORK
LL OROUGH PLUMBING E [ lP�
�
TOTAL FEE GAS PIPING i 41
1 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TESTI�j
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
1
SIGNATURE
OF PERMITTEE FINAL
VALIDATIO ROBERT A /WOOD
CK M O cnsH SUPERVISING MECHANICAL ENG R
[ 0703- "30 5 D 6.00~
DEPARTMENT OF COUNTY ENGINEER PLUMBING
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J FOX, COUNTY ENGINEER ADDRESS
FOR rPPLICANT TO FILL IN LOCALITY
e
BUILDING ter-!! f /y/ �d NEAREST
ADDRESS -S "'9PP ` AY CROSS ST
'a DISTRICT NO GROUP ION PE MIT NO
LOCALITY T
NEAREST �6 A A(J W4
CROSS ST M JJ RE EIVED BY Ready for Inspection DATE ISSUED
�{
OWNER h � D A"S 6-1-7—
' p � INDUSTRIAL '
MAIL `,�+ /Y IC d, / WASTE APPROVAL
ADDRESS fid Ifi ,YJ
CITY TEL NO INSPECTION RECORD
PLUMBER
ADDRESS
CITY �( TEL.NO 0::f /
�+ [^ p STAT
LICENSE NO 7 a /r �. ( COUNT\ W
PERMIT FEES
U
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET(TOILET) @ 080 3 0.
BATHTUB @ 080 0
SHOWER @ 080 y
LAVATORY(WASH BASIN) @ 0 80
KITCHEN SINK @ 0 80
LAUNDRY TUB OR TRAY @ 0 80
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 0 80
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080 `
t
GAS SYSTEM OUTLETS @ 1 00 eqQ
WATER HEATER @ 1 00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ I 00 ROUGH PLUMBING
TOTAL FEE V Q GAS PIPING
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI GASVENT
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 I AM PROPERLY REGISTERED
AND/OR LICENSED AS'REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DE�BED RESV34NIAYR.OPERTY. UTILITY CO NOTIFIED
SIGNATURE `
OF PERMITTE
FINAL
•76A667-DBS 1/63 _ ,
D B S-IV 25M SETS IIr4 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF'LOS ANGELES
WM,J FOX.CHIEF ENGINEER PLUMBING
NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE PgRMIT NO.
ROUGH FIXTURES I� COMPLETE
HEATER CESSPOOL SEPTIC TANK RECEIV BY READY FOR DATE ISSUED
�/,� FIRST INSPECTION � � r`t
AS MISCELLANEOUS1//� / b'L
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB 9 QQ /�
C NAME - ADDRESS ��I�J G.
W
® AD�RES L T' lJ....�.. .. Iln...r LOCALITY �`�' (Cyd✓'�-1�'
TE
� NEAREST
IL I CITY A,.GADI CA MF41S NIA CROGa ST.
co— uI�
CERT No EXPIRES W NAME ✓ �.
LOCATION OF SEPTIC TANK, OR CESSPOOL = MAIL
3 ADDRESS
NORTH O
A CITY TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION-;,
v PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
INa
OWNER
/CORRECTIONS
Vil
SOUTH 1
DESCRIPTION OF WORK z
BATH TUB FURNACE
HOWER DISHWASHER O
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
LOT
OP SINK FLOOR DRAIN
ASH TRAY URINAL APPROVALS
ATER CLOSET DRINKING FOUNTAIN I DATE INSPECTOR S NAME
ATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
ETER GAB AODA FOUNTAIN GAB PIPING
OUTL
GAS VENT I I
CESSPOOL
TAL NUMBER OF FIXTURES SEPTIC TANK I I
POOL AEPTIC TANKSEWERUTILITY CO NOTIFIEDEE
FINAL