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APPLI ATIO/PeFOR PLOMBI G PERMIT
COUNTY OF' LOS ANGELES
DEPS OF'COUNTY ENGINEEE
B INAND SAFETY DMSION MEIINa
JOHN A. LAMBIE, COUNTY ENGINE[R fMDDR
571
COLEMAN W. JENKINS. SUPT. of BUILDING FOR APPLICANT TO FILL IN R O TYPE �7EO!!d HT.
NUMBER FIXTURE OR ITHM EACH PGH
Oglm
WATER CLOSET 1.50 MAIL
/BATH TUB 1.50 ADDS /1{ '��'''�?-1J
SHOWER 1.50 CITY C L / Tm" No. o �/-J ✓/
LAVATORY 1.50 '
SINK 1.50 ADDEM -
DfSItWASHER 1.50 CUT TEL NO. -
CLOTHES WASHER 1.50 STATE LIC _
LICENSE NO. CLASS
SWD6DENG POOL RECEPTOR 1.50 DI■TFHCT N 43R0 [ It ■
LAWN SPRE41 LRR SYSTE 2.00 O
WATER HEATER1.50A� WASTE Vu
OUt
GAS SYSTEM OUTLETS 1.50 DWPECTIOI< RECORD
OUTLETS OVER .30 Q O
5 PER SYSTEM
O r
Plan check fee 2.5% of above. See reverse.
PLUMBING PERMIT ISSUING FEE S 2
TOTAL FEE C�
APPROVALS `rIN• GTon•• ATU R><_
Plan chat licant UNDER-SLAC WORK ,S
Name ROUGH PLUMBING -
Address C OAS PIPING
GAS VENT
City Tel. No HOT WATER HEATER
I HOO OWLED" JHAT I HAVS MILAM THIS APPLICATION
AND OTAT T TH[ A10VS IS CORRS:CT AND Aamm TO Co►vLr PLUMBING FIXTURES
WITH ALL, COUNTY CWDIKANCKS AND STAT[ LAWS RKOULAT'INa GAS TEST
FLUM11Na.
I HLISBIY CEY R
RTIFTHAT I AM FROPiLY R=OI*TS AND/OR UTILITY CO. NOTIFIED
LI CIN§= AS RKQUIRSD WY LAS ANAL" COUNTY STATE OF i
CAUFORNIA OR THAT I AM LKGA- Ovn"R OF, INTlID TO
RX5IDI IN,THE ABO W NTTAL P PITY. FINAL 3 .
■IGNATUR6
OF P'ZRMI CK R. ALLEN, 9UPHRVISIN CHANICAL EN�'R.
PERMIT VALIDATIO CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
_
LAfo4 q.2t 1W 2 -5 D 1 5,TQ—
7e A 667—Cl 817 8/68
APPLICATION FOR PLUMBING PE MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF CO ENGIN
BUMDING AND SAFETY YEER
DIVLSION f7.
JOHN A. LAMBIE. COUNTY ENGIN[[RCOLEMAN W. JENKINS. SUPT. OF BUILDING FOR APPLICANT TO FILL IN R OTYPE _loid ST.
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNER /—
MAn
BATH TUB 1.50 IDIIRFJ!♦ (J
SHOWER 1.50 aTT TEL No. Q( S
LAVATORY 1.50 CommkcrolrQ
SINK 1.50 ADDRESS G
DISHWASHER 1.50 C2TT TEL NO.
CLOTHES WASHER 1.50 LTAT[ LIC
LICENSE NO. CLASS
SWIHLD�'IG POOL RECEPTOR 1.50
DISTRICT NO 07 ZON[ r BY
LAWN SPRINKLER SYBT$M 2.00 ` g
WATER HEATER 1.50 DIDUSTRULL
WASTE APPROVAL z
C:)
GAS SYSTEM OUTLETS 1.50 qmPEFnON RECO
OUTLETS OVER
5 PER SYSTEM .30 [�iJ
Z
Plan check fee 2.5% of above. See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
"TOTAL FEE
APPROVALS DATE INSr[GTOR'1/ION ATU RI
Plan check applicant UNDER SLAB WORK
Name va -Ci DOUGH PLUMBING
Address , GAS PIPING
GAS VENT
City Tel. No. S HOT WATER HEATER
I laxer Ac ow L[DO'[ T 1 HAV[ RSM THIS ArrLIUT1OH
AHD LTAT[ THAT TH[ IS COItlaCr AND AOR= TO COMI PLUMBING FIXTURES
WITH ALL COUNTY ORDINANC=S AND STATC LAWS RS4ULATIN• AS TEST
PLUM [me.
1 H[Rar {SRTIFY THAT I AM F'ROT[kLY RIaiSTCRCD AND/O# UTILITY CO.NOTIFIED
LICCNSm AS RCOUIRSM ■Y LOS AHa[L[S COUNTY AND STATE OF
CALIFORNIA OR TriAT 1 AM TH[ L[QAL OWNZR OF,AND INTIt.ND TO
RKSIDC IN,THC ALOY[ SCD Rol bran rROFC PITY. FINAL
LION ATUR[ 41-C �� JACK R. ALLEN, DU PHRVIlINO ANICAL UNG�R.
OF ATURK T7<G
PEBMTT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CAS1 tr
LtV D 650-
C
79,0447A (QS 41715( -t/77 / 1
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAPS Y DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TY PEI BUILDING ���r �T LST
NUMBER FIXTURE OR ITEM 0 FEE ADORfss 11), 2-1(fGV
WATER CLOSET LOCA1fTYNEAREST
BATH TUB C K)S5 STST.
SHOWER OWNER
LAVATORY MAIL
ADDRESS 1510+1"015,
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR 4aoC�L3LL,Q/1/EXL'/9 Vf}7`/oN
CLOTHES WASHER
f SWIMMING POOL RECEPTORADDRESS y —7;),q1V Ae1oLE S7
LAWN SPRINKLER SYSTEM --� CTTY DAA Z)WJN�(pgkK TEL.NO.
WATER HEATER LICENSE NO. a S'-V 4 T CLASS C—.1.1
mmm, -
GAS SYSTEM OUTLETS W40cr i- UP ,E
INDUSTRIAL o
WASTE APPROVAL
NSPECTK)N RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan chock app
Name APPROVALS DATE De1recr0*M SIGNATIan
lJ<JDER SLAB WORK
Addren ROUGH PLUMBING
C}ty Tel.No. GAS PIPING
1 HMM ACKNOW"U THAT I HAM R1AD THIS APPLYUT10N AND NTATI GAS VENT
rI1Ar T Ia Move Is coRrafcT Am AGRQ To COfIPLY MR}FALL CW wry 011DGiANCdf HOT WATER HEATER
AI[I I=--REGULATING rLUYNTNG.
I He 1Vry CUTFY THAT I Ar PKWMY RKGISTNRID AM/DR 1 r.r.,,,AS PLUMBING FIXTURES
RLDUDKD IY Los A110�1 COUNTY AJID STATC O!<CALI'd RNM OR THAT 1 Ar TFC ` T�
LIGAL CWWn Of,AND VCrEW TO I DI THE ADOV[D[SCICPID Rl.SIDINTNL
nae UTY. uT I LITY cb.tion Fi ED
D Ia NAru IRfi
a PeRNf, FINAL Z
PLAN CHEO(VALIDATION pL r.a curl PERMIT VALIDATION ® r.O. CASH
1 4 8 4-,'D J& 6 6 0 1 3.0 O ff,