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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY, ENGINEER
BUILDING AND SAFETY DIVISION •BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER % ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING •'^-rte / 7 1 '
LOCALITY
FOR APPLICANT TO FILL IN NEAREST /
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER'CLOSET $1.25 MAILIII
BATH TUB 1.25 ADDRESS
CITY TEL. NO.
SHOWER 1.25
LAVATORY 1.25 CONTRACTOR /
/ SINK 1.25 ADDRESS �/ 3 +
DISHWASHER 1.25 CITY A D• TEL. N . .4
.4 CONTRACTOR'S ^/ 7� STATE
LAUNDRY TUB 1.25 REGISTRATION NO. // V C/ COUNTY ❑
0
CLOTHES WASHER 1.25 DISTRI T NO. GROUP ONE SSED BY
/n WATER HEATER 1.50 � Z/
GAS SYSTEM 47 OUTLETS 1'5 INDUSTRIAL IL
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 IN/SPECTION RECORD
y/ U
AD-
U
W
a
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ ("2 r pO UNDER SLAB WORK
ROUGH PLUMBING N.S —t
n TOTAL FEE19- GAS PIPING \
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
_ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
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 LOS ANGEL COUNFY AND STATE OF GAS
CALIFORNIA OR THAT THE LEGAL NER AND INTEND TO 1(i,.4J1/1,� 1A �
RESIDE IN,THE ABOVA043fSCRIBED RE51 IAL ROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OFPERMITTExAmFINAL 1
V LIDATION ROBERT A. OOD U
CK. M.0. CASH SUPERVISING MECHANICAL ENG'R
Leo5662\ NOV 6 5 D 12.50
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY `
WILLIAM J. FOX, County Engineer
DISTRICT NO. GROUP ZON .
FOR APPLICANT TO FILL IN
5 1 --7-- A-1
PLUMBER W I EY BOULEVARD PLUMBING CO. RECEIVED
BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS VALLEY BLVD. a e I Z.--31-53
BUILDI NG
CITY ROSIL7MEAD TEL. No. AT, 2-2719 ADDRESS01
COUNTY
®/
LICENSE NO. ✓�>14 EXPIRES ?`' LOCALITY z.�,�
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE _OWNER
MAIL
WATER CLOSET(TOILET) 0 0.50 /Q� ADDRESS
/ BATH TUB @ 0.50 v CITY TEL. No.
SHOWER a 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE A13OVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
i CERTIFY THAT I P059ESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY O.SO ANGELES COUNTY LICENSE, OR i AM THE LEGAL OWNER
OF THE REBIDENTIAy PROPERTY DESCRIBED OVE.
GAS SYSTEM OUTLETS a 0.50
��••f1s�� SIGNATURE OF l '
WATER HEATER 0.513 /_�y6y PERMITTE
SLOP SINK @ 0.513 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN tQ 0.50
DISHWASHER 0.50
DRINKING FOUNTAIN 0.50
URINAL 0.50 Q
HOUSE SEWER 0.50 _Z
MISCELLANEOUS
0
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING //
GAS PIPING /
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
p `
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT 1.00 GAS TEST AL
TOTAL FEE '60 UTILITY CO.NOTIFIED
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FINAL
76A667 DBS##17 6-52