HomeMy Public PortalAbout5323 GOLDEN WEST AVE_Plumbing__ 76 A 667,- C E•817 7-69
APPLICATION FOR - PLUMBING PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION ADDRESS BVIUESS G+�
JOHN A. LAMBIE, COUNTY ENGINEER `J
COLEMAN W. JENKINS SUP T OF BUILDING LOCALITY'—�
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST '
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1 50
MALL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY -TEL. NO.
LAVATORY 1.50 CONTRACTOR G
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY w elamzbpL, TEL. NO.j?,55 226,1
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO �' CLASS
SWIMMING POOL RECEPTOR 1.50 '�
DIS{TR�ICT NO. OU Q NE ttgbESSED BY
LAWN SPRINKLER SYSTEM' 2.00
WATER HEATER 1.50 WASTE APPROVAL Q
GAS SYSTEM OUTLETS 1 50 ` INSPECTION REC R_D u
OUTLETS OVER 30 7 r� O
5 PER SYSTEM (/
O.
Vf
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Pian check fee 25% of above. See reverse.,
PLUMBING PERMIT ISSUING FEE 3 1 2 •00
TOTAL FEE C�
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ; ROUGH PLUMBING
Address GAS PIPING
GAS VENT '
CLA
t Tel No.
HOT WATER HEATER
REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION "
TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
ING
REBY CERTIFY THAT I AM PROPERLY REGISTERED AN UTILITY CO NOTIFIED
ED AS REQUIRED BY LOS ANGELES COUNTY•IAND STATE OF ((�
RNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO J
THE AB ED RESIDENTIAL PROPERTY FINAL
TOR JACK R. ALLEN, SU VIS NG CHANICAL ENG'R
ERTTE -
PERMIT VALIDATIO =— - 0 CASH
PLAN CHECK ALIDATIO CK M O CASH
�,i^,-, 0 0 8 5— rin l .5 D .Q� c
76A687q CE#817 4-64 C /�
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY `
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. r
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
BATH TUB 1.25 ADDRESS Q
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 r j CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25
CITY C TEL. NO.
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. 1 COUNTY
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PR SSED BY
WATER HEATER 1.50
GAS SYSTEM_ OUTLETS 1'� ^O INDUSTRIAL 0
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
nZ�Ej ea✓� �j �1�� O
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APPROVALS DATE INSPECTOR S SIGNATjRg
PERMIT S 2 00 UNDER SLAB WORK �°� �� ✓��
pp ROUGH PLUMBING p 4r� -+'
TOTAL FEE , GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ..rte p
ad
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY S ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I A T LEGAL OWNER OF,AND INTEND TO /_gyp
RESIDC IN,THE ABOVE D E REST ENTIRE PROPERTY UTILITY CO NOTIFIED Wit, r
SIGNATURE a
OF PERMITTEE FINAL
VALIDATION RObERT A WOOD ,
cK M O CASH SUPERVISING MECHANICAL ENG R
LACI 9 7 2 9 ti;�R 1 a 5 D 1 6.25-