HomeMy Public PortalAbout10602 KEY WEST ST_Plumbing__ Dss.17 3'33 - APPLICATION FOR PLUMBING PERMIT 1
DBS-17 ,
DIVISION OF BUILDING AND SAFETY
f Department of County Engineer
County of Los Angeles
BUILDING L /_gu p /V���eS
WM.J. FOX, COUNTY ENGINEER ADDRESS ((88 I f
• CASSATT D. GRIFFIN SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN CROSS T pa e e s
OWNER 1 y5 7sJcs Ia �i� DISTRICT t00 GROUP ZONE READY FOR INSPECTION
MAIL T
ADDRESS�� O'1►`�.�T 'GS / — �.�
}� 1 INDUSTRIAL 1
CITY e `� (� TEL NO ! WASTE APPROVAL I
PLUMBER N�.w �� ��.. S�l Al G*74'A/ INSPECTION RECORD ,
ADDRESS 3(0 A /
CITY b N 7k TEL 'NO 1"6
LICENSE NO 4
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO @ O 80 " - APPROVALS
DATE INSPECTOR S SIGNATURE
GAS SYSTEM OUTLETS @ 1 00
WATER HEATER @ 1 00 UNDER SLAB WORK iI A
ROUGH PLUMBING
PERMIT g 1 00
GAS PIPING,
TOTAL FEE t,Y GAS VENT
1 HEREBY ACKNOWLEDGE,THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITH ALL COUNTY ORDINANCES AND STATE_ LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 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 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIA PROPERTY
SIGNATURE
OFPERM
ER
OF PERMITTEE I e+w A444���!!!-r'���i/1 FINAL < .f72
EMINIUMM
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION R. A.WOOD, CHIEF PLBG INSPECTOR
A8 5 0 r- SEP30 3 1 .80 `�
76A667 LCE-817) - 1/75 • __,_
APPLICATIONF R PLU ING PERMIT -
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDING X06
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY /� p G
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM p FEE OWNER
WATER CLOSET 200 60 —
j
MAIL / ,0Z t
BATH TUB 2 00 ADDRESS
SHOWER 200 V� CITY P TEL NO
LAVATORY 2 00 CONTRACTOR
SINK 2 00 ADDRESS
DISHWASHER 2 00 CITY �f�j TEL NO �6 71
CLOTHES WASHER 200 STATELICENSE NOd� / �'-7 CLIC
LASS L/
SWIMMING POOL RECEPTOR 200
DISTRICT NO IG]rP ZONE PRO ESS BY
LAWN SPRINKLER SYSTEM 2 00WATER HEATER 200 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 200 INSPECTION RECORD a
OUTLETS OVER 30 V
5 PER SYSTEM
• O
V
W
d.
N
iZ
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEES O
TOTAL FEE
APPROVALS DATE INSPECTOR 9 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING fly iy
Address GAS PIPING 7' 1r,-e — "*--
City Tel NO GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING _FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST f 'G�7j// cr •'—C
PLUMBINGAK
I HEREBY CERTIFY THAT I AM PRO REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LO LES OUNTY AND STATE OF
CAL I FORNIA OR THAT 1 AM T L ER OF, AN " INTEND TO �)
RESIDE IN THE ABOVE DESC ED NTIAL PkQPER
FINAL a,•� i�
SI GNATU RE -„
OF PERMITTEE
PERMIT IDATION cK M, CASH
PLAN CHECK VALIDATION C M CASH (/ J
1 6 4 nrT`16 5 D 1 6.5 0