HomeMy Public PortalAbout10871 GRAND AVE_Plumbing__ 76A667 (CE-817)-8-71
APPLICATION FOR PLUMBI G PERM
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ^ / v
ADDRESS G/ �(f
LOCALITY
i
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1.75 OWNER
MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY TEL. NO.
LAVATORY 1.75 CONTRACTOR
-
SINK 1.75 ADDRESS s
DISHWASHER 1.75 CITYTEL. NO. —'7
CLOTHES WASHER 1 75 STATE 1 �� LIC
LICENSE NO. - CLASS
SWIMMING POOL RECEPTOR 1.75
D^ISTRIC NQ./ GRO P Z E R ES 8Y
LAWN SPRINKLER SYSTEM 1 75 a//
WATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD (�
OUTLETS OVER
5 PER SYSTEM 30 Z
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Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
s/
APPROVALS DATE INSPECTOR'S 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 I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
A♦SIDE IN THE ABOVE DESCRIBED RESIDE T
EESIDENTJA L PROPER/TY. FINAL
SIGNA TUBE // y !/'
I Alt
OF PERMITTEE ((( CCC C. ��/���///"""AAA���SLiiQQQ/// I
PERMIT VALIDATIONCK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH pigs 5A! p�
76AG67 APPLICATION FOR PLUMBING PERMIT 1
DBS-1710-55
OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles ADDRESS10871 Grand ave,
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING
LOCALITY '�','jty
FOR APPLICANT TO FILL IN I NEAREST
cRoss sT. a ' P. ,
71
OWNER �TB.TZe? (�dc$Urne —CONTtt DISTRICT NO. GR P ZONE READY FOR INSPECTION
MAIL
ADDRESs2519 S.Santa Anita ave, INDURIAL
'� �-
CITY Arcadia TEL. NO. DO 74748 WA TH APPROVAL
PLUMBER Saguaro Const Inc. �� �, ,�(�INSPECTION RECORD jd-jvy✓
ADDRESS 8819 E. Nhittiey Blvd, 0i� IAl
CITY Pico. p TEL. NO. OX 51617
LICENSE NO.145561 SIJ 36
NUMBER TYPE OF FIXTURE OR ITEM I FEE �7 /
WATER CLOSET (TOILET) @ $1.00 3 /00 (i /,7r y
1 BATH TUB @ $1.00 1.00
2 SHOWER @ $1.00 2.00
2 LAVATORY (WASH BASIN) @ $1.00 2,00
1 KITCHEN SINK @ SI.00 1.00
DISHWASHER @ $1.00 //��
2 LAUNDRY TUB OR TRAY @ $1.00 2 0
CLOTHES WASHER @ $1.00
2 e�
WATER HEATER @ $1.00 2,00
1 GAS SYSTEM @ $1.00 l OO r47
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APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 7 00 ROUGH PLUMBING 1
GAS PIPING
TOTAL FEE 15.00 GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST '� L fG�.r
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGA OWN THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL
SIGNATURE
OF PERMITTEE FINAL �•� .wt
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
CASH