HomeMy Public PortalAbout10764 FAIRVIEW AVE_Plumbing__ r
76Aa6,jj CE-817) 5/73 { _
• , APPLICATION FOR,-PLUMBING PERMIT' , '
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TOBUIILDING
'ADDRESS
HARVEY T BRANDT, COUNTY ENGINEER _ t
LOCALITY I'
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST c
rNUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1 75 1 OWNER
MAIL-
BATH
- r
BATH TUB 1 75 ADDRESS 6
SHOWER 1 75 CITY kZ7TEL NO
LAVATORY 1 75 CONTRACTOR
SINK 1 75 ADDRESS
DISHWASHER 1 75 t' CITY ` TEL NO
CLOTHES WASHER 1 75 yr STATE LIC
r+ f
SWIMMING POOL RECEPTOR 1 75 , LICENSE NO CLASS
DISTRICT NO GROUP ZONE �ROCE SED BY
LAWN SPRINKLER SYSTEM 1 75
WATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM , OUTLETS 1 75 INSPECTION RECORD C:)
OUTLETS OVERv
30 + r
5 PER SYSTEM
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Plan check fee See Reverse
,PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE '5-,
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant
UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING /�� •�
City Tel NO / GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
,ALL ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMNG GAS TEST I ,�/�7'/ , �
B
I HEREBY CERTIFY THAT I AM'PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED +`
`LI-LENSED AS REQUIRED BY LOS ANGELES COUNTY-AND STATE OF J, .
CALIFORNIA OR THAT I AM.,THE LEGAL OWNER'OF, AND INTEND TO
RESIDE IN THE ABOVE ZDE:D,:R:E:Sn1DEPROPERTY ? /FINAL , i�SS DE TU RE PERT/ 1 _OF PE RMI TTE r=" '�"„r �,�e� 1 r `
PERMIT VALIDATION
K O �4"H
PLAN CHECK VALIDATION CK M O CASH
5 9`:OCT --9, 5 0 �!'! 5 ®9b ,
76A667 CE#817 5 61
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS 10764 Fairview
WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY InleJ
FOR APPLICANT TO FILL IN CROSS ST
NUMBER FIXTURE OR ITEM
OWNER
Scott & Coulter
1 WATER CLOSET MAII.
BATH TUB ADDRESS
CITY TEL. NO
SHOWER
LAVATORY CONTRACTOR
1
1 SINS ADDRESS 1201 So. Tenth Ave
DISHWASHER CITY Arcadia TEI" NO Hi 7r7386
CONTRACTOWS154034 " rl
1 LAUNDRY TUB REGISTRATION NO. COUNTY
CLOTHES WASHER DISTRICT NO GROUPA07
P SED BY
1 WATER HEATER � IL
1 GAS SYSTEINDUSTRIAL
M WASTE APPROVAL
INSPECTION RECORD
O
U
W
d
Vf
$100 PER ITEM
OR FIXTURE $ N `'Z APPROVALS DATE INSPECTOR 6 SIGNATURE
PERMIT $ 2 00 UNDERISLAMWORKqrI A, /�
TOTAL FEE ROUGH PLUMBING LHA4,/$1 ./l
GAS PIPING a
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AHD STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT l
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER r��
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY GISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUI ER'II-SY LOS ANG ELE U TY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGA OF THE ABOVE
DESCRIBED RESIDENTI PEB7Y UTILITY CO NOTIFIED P '
SIGNATUREA
OF PERMITT I
FINAL G,2
VdKAT
ATION ROBERT A WOOD
O CASH SUPERVISING MECHANICAL ENG R
LG'O 5,4.4QI JM21 5 0 1125",
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