HomeMy Public PortalAbout6044 1/2 KAUFFMAN AVE_Plumbing__ 76A667-CE817- 11-57
APPLICATION FOR PLUMPIN PERMIT 4
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ,
JOHN A. LAMBIE, County Engineer ADDRESS
CASSATT D. GRIFFIN, Sup't of Building
LOCALITY !e., .- ( +i
FOR APPLICANT TO FILL IN NEAREST ',
NUMBER FIXTURE OR ITEM CROSS ST. C.
I WATER CLOSET OWNERMAIL
BATH TUB - ADDRESS r � ifL'
SHOWER CITY y',l C TEL. Nb1�,' l. ✓r
j LAVATORY CONTRACTOR
SINS ADDRESS
y
-- CITY r/ TEL. NOW""
DISHWASHER L
CONTRACTOR'S r STATE
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER GROUP ZONE READY FOR INSPECTION
DISTRI
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
l
APPROVALS
@ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FIXTURE $ 7 l (_;
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LI CATION GAS VENT
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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY ,LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 Aplf THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDENTIAL P OPE .
SIGNATURE j//�
OFPERMITTEE FINAL
16-
'
ROBERTA.WOOD.
VALIDATIQN SUPERVISING MECHANICAL ENG'R
CK. M.O. CASH
CE B17 7(
CE H 1 (REV.6/78)
P)S
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE BUILDING
[,sr/,l ":� „�✓ �,/� '�' -� `
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
' CITY TEL.NO.
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS APPROVALS DATEINSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK d
5 PER SYSTEM ROUGH PLUMBING O
GAS PIPING LJ
W
GAS VENT J
LL
HOT WATER HEATER y.
GC
PLUMBING FIXTURES Q
GAS TEST O
Plan check fee UTILITY CO.NOTIFIED
PLUMBING PERMIT ISSUING FEE$ W
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATION
Name �?
Address
City r Tel.No. f
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REOU IR ED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE R.
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. .
SIGNATURE
OF PERMITTEE
DISTRICT NO. PROCESSED BY
INDUSTRIAL
WASTE APPROVAL
II