HomeMy Public PortalAbout5616 LOMA AVE_Plumbing__ `•76A6.67 LCE-81.77.- 5/73
APPLICATION, FORPLUMBING PERMIT
COUNTY OF-LOS.ANGELES'
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FAD
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MAKE CHECKS PAYABLE TO r,} S;'S.616 N Zoma `AVeHARVEY T. 13RANDT, COUNTY ENGIN'EERr' TY' Temp, e, lty
FOR APPLICANT TO FILL'IN (PRINT'.OR TYPE)',. TST.Nq'61 Dr. to Duffy St,
NUMBER FIXTURE OR ITEM '. @ FEE -
OWNER •Vernon ,Akexs
WATER CLOSET 1•.75- MAIL-
BATHTUB
AILBATHTUB 1.75
ADDRESS `5616 N Lome, 'Ave ..,
f
SHOWER . 1.75 Temple Cit' , 286 :6248
CITY TEL. NO
:LAVATORY 1.75
CONTRACTOR •
H atin Co•
SINK 1.75 ADDRESS395 F', .Valley Blvd.,
DISHWASHER 1'.75. t,. .# i. an, G a, rie .. :_ -
CITY TEL: NO.
CLOTHES WASHER' 1.75 STATE LIC
LICENSE.NO: 14 .$ CL'ASg:,. +20
SWIMMING POOL RECEPTOR -1.75
DIS TRI T f�O.(,// GRO P Z O ES .D B'V
`..LAWN:SPR INKLER SYSTEMt.75 J •.p U 1l ,,
WATER HEATER - 1.75 IND6STRIAL -
�1�
�7 WASTE APPROVAL d
1 GAS SX15
STEM . OUTLETS 1.75 INS4CjION RECORD �
OUTLETS OVER30
5 PER SYSTEM O
" - V
GO
N
Plan Check fee 'See Reverse
PLUMBING PERMITISSUING FEE $ 3 00
TOTAL FEE
_ -.
APPROVALS' DATE 'INSPECTOR'S SIGNATURE
Plan check applicant' UNDER SLAB WORK
Name ROUGH PLUMBING
Address... ... - ... . ., GAS PIPING. - ..
City. _ Te-I. No. GAS.VENT
- HOT WATER HEATER .
• I H.EREBY,ACKNOWLEDGE.THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE. r5 CORRECT AND A GRE E';TO COMPLY PLUMBING FIXTURES _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGt
PLUMBING. GAS TEST
I: HEREBY CERTIFY'THAT I -AM PROPERLY R ,Gi'S•T6AED AND/OR �•
,i "UTILITY CO. NOTIFIED
;_LICENSED AS REQUIRED BY L S ANGELES COWNTY.
CALIFORNIA OR THAT. I AM E LEGAL OW R OF, AND IN T TO
RESGNATU RE I!DE IN THE ABOVE DE BE RESIDE T AL OPERTY. NAL '
OF PERMITTE -
PERMIT VALIDATION. CK. M.O. CASH
,'PCAN CHECK V LIDATIO`N CK. M.0. CASH
76ASW�ll� ^ ;-s, APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
F❑ APPLICANT T❑ ILL IN DIS R C GROUP NE s.
All
PLUMBER- EI BY READY FORD TE ISSUED
t� FIRST INSPECTION
ADDRESS
/_15 BUILDING
CITY /_/
�y Qp� TEL NO. (� ADDRESS (Q (®
LOCALITY
Llrd NSE NO. v` EXPIRES
( i NEAREST' -
PERMIT FEES CROSS ST. /p
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) @-0.50 ADDRESS ,
Al
BATH TUB @ 0.50 10 CITY jj TEL. No./ [-�" )
SHOWER @ 0.50 �( 1 HEREBY ACKNCWI(EDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 .0 APPLICATION AND STATE THAT THE ABOVE IB CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0,50 .AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID 'LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM'THE LEGAL OWNER
DA3 SYSTEMOUTLETS @ 0.50OF THE RESIDENTIAL PROPERTY DESC BED BOVE.
`
SIGNATURE OF
WATER HEATER @ 0.513 PERMITTE
Y
SLOP SINK @ 0.50 IN PECTION RECORD
FLOOR BINK 93.SO r
FLOOR.DRAIN @ 0.50 v
DISHWASHER @ 0:50
DRINKING FOUNTAIN @ O.SO Aipe-4)e
URINALs
a.SD J
d
HOUSE BEWER @ 0.50 Z
MISCELLANEOUS - 5
a
APPROVALS
DATE INSPECTOR'S NAMU
ROU13H PLUMBING
GA 9 PIPING ! d t;{• i /J
' GAS VENT °"�� /1
CESSPOOL @ j,.00 CESSPOOL `
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT-( ) @ 1.00 .SEWER
PERMIT • 1.00 GAS TEST f/J
jt' UTILITY CO.NOTIFIED _ _4111111 `
TOTAL FEE.
FINAL �/