HomeMy Public PortalAbout5703 GOLDEN WEST AVE_Plumbing__ - a� �76A667
(CE-817) - 5/73APP'LIC ° PL MBING- PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
D NIS
MAKE CHECKS PAYABLE TO
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RESS /t/= �DL'�E%J `L(JeST v�:HARVEY T. BRANDT, COUNTY ENGINEERA CITYT t CEFOR APPLICANT TO FILL IN (PRINT OR,TYPE) RESTSS ST
NUMBER FIXTURE OR ITEM @ FEE
OWNER, -� j�
' WATER CLOSET 1.75
MAIL R
BATH TUB 1.75 ADDRESS
SHOWER 1,75 CITY TEL NO. 7 47,6
LAVATORY 1,75 CONTRACTOR w
SINK 1.75 ADDRESS
DISHWASHER1.75 CITY ' NO
CLOTHES WASHER 1.75 STATE LIC
SWIMMING POOL RECEPTOR 1.75 LICENSE NO : •' -CLASS
DISTRICT NO GROUP E CESSED BY,
= LAWN SPRINKLER SYSTEM 1.75 -
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL >
GAS SYSTEM OUTLETS 1.75 CD
INSPECTION RECORD CD
OUTLETS OVER v
5 PER SYSTEM 30 C
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f zA !f\� 25w
PA P4
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
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
WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
I HEREBY CERTIFY THAT 1. AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
CALI FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO _
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROP TY FINAL
SIGzz
NA TU RE '
OF PERM[TTE
�PEVALIDATION CK M.0 CASH
PLAN CHECK VALIDATION CK M O. CASH '
6 3 r NOV 5 D 8.2 5 ®ao
76A667 -CE#B17 2-62 TEMPLE C97 '
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING f` 4
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN, Sup T OF BUILDING LOCALITY
FOR APPLICANT TO FILI: IN NEAREST
CROSS ST. _ i
NUMBER FIXTURE OR ITEM EACH FEE
OWNER yJ4�
WATER CLOSET $1.25 ,�-�7
BATH TUB 1.25 ADD S t:/ / �YL_
SHOWER 125 CITY• TEL. NO.
LAVATORY 1.25 CONTRAC OR ,
SIN$ 1.25 ADDRESS f ® `
DISHWASHER 1 25 CITY TEL. NO J7J
LAUNDRY TUB 1.25 CONTRA OR'S STATE
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ONE PROCESSED BY
WATER HEATER 1.50 3•� `� (�� �� �'Qr
GAS SYSTEM- OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
A.
O
U
0
Lu
CL
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
y
ROUGH PLUMBING
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 r A A
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 OS A S COUNTY AND STATE OF GAS TEST,
CALIFORNIA OR'THAT 1 A HE GAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DE RIB RESIDENTIAL PROPER UTILITY CO NOTIFIED
SIGNATURE o
B d A A
OF PERMITTEE FINAL �?/
r VALIDATION ROBERT AJWOOD Y
CK M o cns SUPERVISING MECHANICAL ENG'R
17 2 OZ AL23 5 U 3.50"