HomeMy Public PortalAbout10066 GREEN ST_Plumbing__ 78A567APPLICATION FOR PLUMBING PERMIT
10 1
DBS-17 .55
DIVISION OF BUILDING AND SAFETY
Depaxtment of County Engineer
County of Los Angeles B U I LD I NG / / ,y
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS Q�� �Y(.Gam,
CASSATT D.GRIFFIN$UP'T OF BUILDING LOCALITY
FOR APPLICANT TO FILL INNEAREST
CROSS ST.
OWNER /f
;� DISTRICT NO. GROrZ E I READY FOR INSPECTION
MAIL 11—
ADDRESS /OO /1/
INDUSTRIAL
CITY 4n TE O. WASTE APPROVAL
PLUMBS // e INSPECTION RECORD
ADDRES IV IO W4
CITY( r. � TEL. NO.
-17
LICENSE NO. y �,:q
NUMBER TYPE OF FIX RE OR ITEM I FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ S1.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00 _
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00 //ff
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING "'
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
e ,
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OW OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROP RTY
SIGNATURE
OF PERMITTEE FINAL
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATIO OBERT A. WOOD, CHIEF PLBG. INSPECTOR
CH. Y.0. CASH
t,.An3 1 FFS 17 3
2.00 �►
v �
J
� DEPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS J
FOR APPLICANT TO FILL IN LOCALITY C
BUILDING NEARE
ADDRESS °, CROSS ST.
i DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY 1e0r1r�ti1 !
NEAREST ` `� t f
CRnSS ST. A w A'u CJ:AEIVED BY Ready for Inspection DATEISSUED
OWNER Ak \Lr ed `Zy,- e (r
MAIL INDUSTRI {, 1
ADDRESS `, W i 4 -1 II j� M1�,t� p WASTE APPROVAL
CITY L 0 1 Ai%R Q_14PI TEL.NO. 1�V `�'O ZJ (0 INSPECTION RECORD
PLUMBER it-
ADDRESS 5 W 3 r Gt _�_�r i. !/1 I /Al
CITY LOS A V�-!SQkC''% TEL.NO. AD 40 �(
❑STATE
:CENSE NO. C)W 41 FI COUNTY
J
PERMIT FEES a
z
:'JMQER TYPE OF FIXTURE OR ITEM FEE
-2. WATER CLOSET(TOILET) '2.@ 0.80 S (o G R
BATH TUB @ 0.80 SO O
SHOWER @ 0.80
LAVATORY(WASH BASIN) L@ 0.80 G d
KITCHEN SINK 1 @ 0.80 Lri C
LAUNDRY TUB OR TRAY 1 @ 0.80 so
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM...--.:�--OUTLETS @ 1.00 00
WATER HEATER 1 @ 1.00 Q
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
Oat
UNDER SLAB WORK Off
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE G Q GAS PIPING fi
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
"AT
ION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
NiHEREBY CERTIFY THAT I AM PROPERLY REGISTERED {
Al)/OR LICENSED AS REQUIRED BY LOS ANGELFS COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESID NTIAL P PERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE - .....-..........----...-........---
; L FINAL
76A667 DES 17 1/53