HomeMy Public PortalAbout5645 HELEO AVE_Plumbing__ ISA667-CER617 9/63
APPLICATION - FOR. PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING / s
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS �7
WILLIAM A. JENSEN. SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
sr.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB L25 ADDRESS
SHOWER 1.25 CITY TEC. NO.
LAVATORY 1.28 CONTRACTOR
SINE 1.25 ADDRESS 6S'
DISHWASHER 1.25 CITY TEL. NO. -Q07?
LAUNDRY TUB 1,25 CONTRACTOR'S STATE
REGISTRATION NO. 9 COUNTY ❑
CLOTHES WASHER 1,25 DISTRICT NO. GROUP ZONE P ESBED BY
WATER HEATER 1.50 Ir J
CAS SYSTEM OUTLETS 1.50 INDUSTRIAL d
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .20 U
INSPECTION RECORD
I te/ o
Z
✓ �7
I APPROVALS N re'DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING �/ 'A,a-
TOTAL FEE GAS PIPING - �j'X6yCI r
1 HEREBY ACKNOWLEDGE THAT 1 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 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES J�•� ,
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AN THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABO OECC D RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
L
SIGNATURE • IJA
OF PERMITTEE
FINAL (/a
LIDATION ROBERT A. WOOD
c m.D. CASH SUPERVISING MECHANICAL ENG'R
Lilo e 5 2 11� KAY �1 , 5 D 16.25,
T6A667 (CE-8I7) - 1175 C` f 6 ' - 1 £VN-li)III�F' \-(' +y
APPLICATION FOR PLUMBING PERMIT {�
COUNTY OF LOS ANGELES u
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
.MAKE CHECKS PAYABLE TO: FADDRE
G
S � _ ,-
HARVEY T. BRANDT, COUNTY ENGINEERvFOR APPLICANT TO FILL IN (PRINT OR NPE) / / �T. L ok NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET2.00 rz bl$ 14.
BATH TUB 2.00 S
SHOWER 2.00 CITY , + TEL. NO. -
LAVATORY 2.00 CONTRACTOR I
/E
SINK 2.00 ADDRESS p O GT
DISHWASHER 2.00 CITU-77
���--YY /c TEL. NO.
CLOTHES WASHER 2.00 LICENSE NO. f��j CLASS
SWIMMING POOL RECEPTOR 2.00
DISTRICT NO.GROUP NE CESS D B
LAWN SPRINKLER SYSTEM 2,00 /.�Q P
WATER HEATER 2.00 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00 INSPECT{ON RECORD d
OUTLETS OVER
5 PER SYSTEM .30 S�7 ✓/Vr�(' /L��G�-!'�C.•...�C--yV
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE S q fiEA
TOTAL FEE (�
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant ER SLAB WORK
Name GH PLUMBINGAddress PIPINGCity Tel. No. VENT WATER HEATERI HEREBY ACKNOWLEDGE THAT I HAVE READ .THIS APPLICANOSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COBING _FIXTURESWITH ALL COUNTY ORDINANCES AND STATE LAWS REGULTESTPLUMBING.I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANITY CO. NOTIFIEDLI CEN$ED AS REQUIRED BY LO5 ANGELES COUNTY AND STACALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEN
REST OE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE IJ-'
OF PERMITTEE l�
PERMIT VALIDATION 1 .0. CASH
PLAN-CHECKVALIDATION CN. M.O. CASH `
„y 9 2 2'�<R1L 1 0.5 0 ,&9c,
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