HomeMy Public PortalAbout10321 FREER ST_Plumbing__ 76A667
DBS-f 12.54 APPLICATION FOR PLUMBING -PERMIT
� •
., DMSION'OF BUILDING AND SAFETY
IJT Deportment of County Engineer .cam
County of Los Angeles BUILDING ® � p� Ir e� p R
WM.J. FOX, COUNTY t-NGINEER ADDRESS Fir 1� F�
CASSATT D. GRIFFIN, SUPT of BUILDING _ ��'
LOCALITY Q , C +
OR APPLICANT_ TO FILL IN NEAREST `"ti'
,y► ' �/ CROSS ST.
OWNER IC.f N DISTRICTr. I GRO`P I Z EREADY FOR INSPECTION
MAIL
i ADDRESS '
• _ .INDUSTRIAL
3 CITY TEL. NO. WASTE APPROVAL
PLUMBER j . ® R V4C j F' J'�, INSPECTION RECORD
ADDRESS '4 B ® :so , G ill' F I E L1V'
�0
CIT'1909_Te�fj OTEL. NJh 1114 a
LICENSE NO. 4. 3 W
NUMBER TYPE OF FIXTURE OR ITEM FEE -
1 WATER CLOSET (TOILETY IZ6
BATHTUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER '
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO. /� @ 0.80 APPROVALS
_ DATE INSPEGTOR•S SIGNATURE
GAS SYSTEM OUTLETS @ 1.00
UNDER SLAB WORK) i
WATER HEATER @' 1.00 0 �
- ROUGH PLUMBING �S - �mil
PERMIT S I OO GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER _
AND STATE THAT THE ABOVE ICORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCEE S AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING. �.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
CE
LICENSED AS REQUIRED BY LOS ANGELES OND STATE OF, UTILITY CO. NOTIFIED I'
' CALIFORNIA OR THAT 1 AM THE LEGAL OWNERWNER OOF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE Cali)DI Vim p
OF PERMITTEE B' ++'"' FINAL
WfLLiAM J. FOX,-Co�in�}Y ENGINEER VALIDATION '
__Y..
0,5 -2'1 7 �V Q 3 1 .8 0 to
i BT 1
DEPUTY -
76A667C(tE 817-A)- 11/76 /��'��✓�� �[ ( Y
• APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDINGL'
NUMBER FIXTURE OR ITEM ® FEE ADDRESS �b 3 A/ F/l Q Q
LOCALITY
WATER CLOSET
NEAREST
BATH TUB CROSS ST �N
SHOWER OWNER e
LAVATORY MAIL /
ADDRESS /0 �¢ /Z-
SINK
SINK CITY & 4 TEL NO 4Q'
DISHWASHER CONTRACTOR C_
CLOTHES WASHER '
ADDRESS 3 SogSA L Q.-Lt SO
SWIMMING POOL RECEPTOR
CITY• GOv� _ TEL NO. 33d ,55d
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO ^' L CLASS
GAS SYSTEM OUTLETS DISTRICT NO GROJ �NE O
O ED BY
� .'D B
OUTLETS OVER
5 PER SYSTEM INDUSTRIAL 6
WASTE APPROVAL
INSPECTION RECORD v
cc
{M
Plan check fee m.
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING —� Atd'L{
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT '
THAT THE ABOVE IS 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 FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST' ' r.
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY
//////J��� UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION cK M O CASH
3 1 1.r*_t4AY 5 5. D 1 0.0 J Amb
Os