HomeMy Public PortalAbout6119 LOMA AVE_Plumbing__ 76A667.(CE-817) - 5/73 l O
APPLICATION ORR+��•JJJPLLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT ORITYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE OWNER
WATER CLOSET 1.7
MAIL .,
BATH TUB 1,7 ADDRESS J
SHOWER 1.15 CITY TEL. NO. 4-'7
LAVATORY 1. 5 CONTRACTOR
SINK 1. 5 ADDRESS s ��
DISHWASHER 1. 5 CITY � TEL. N0.
CLOTHES WASHER 1. 15 STATE / LI
LICENSE N0. ,� ` CL SS
SWIMMING POOL RECEPTOR 1, 15
TRICT O. UP E P CESSED BY
LAWN SPRINKLER SYSTEM 1. 5 l
WATER HEATER 11, 5 INDUSTRIAL
WASTE APPROVAL >
GAS SYSTEM OUTLETS 1.35
INSPECTION RECORD U
OUTLETS OVER 30
5 PER SYSTEM
h-
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w
CL-
Plan
ZPlan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 7
_ APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING r� {
City Tel. NO. GAS VENT .
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST -1 97,,W
l'
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED v�
LICENSEDAS REQUIRED BY LOS ANGELES C UN AN STATE F
CALIFORNIA OR THAT I AM THE LEGAL OW R INTEN 0
RESIDE IN THE ABOVE DESCR RE IDEN AL R R Y. FINAL 17-1-M
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION CK. 0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH /
1.3 4to-JUL 1 5 0 4.7 5 ASe
76A667 OBS 17 11-50 - APPLICATION FOR PERMIT
- DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES •
WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1
FOR APPLIOANT TO FILL IN IST O. GROUP ZONE: .
Y' I 1�eo/
PLUMBER Lyman F. Merry READY FOR
RIC E VED BY DATE ISSUED
825 East roa �j� , FIRST INSPECTION
ADDRESSBUILDING
�'(M�"L �T O �,
CITY San Gabriel TEL NO.AT 10385 ADDRESS 61l N. Loma
CDUNTY
LICENSE NO. 686 EXPIRES 6/30/52 LOCALITY Temple City
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Vern Wimmerstadt
1 WATER CLOSET(TOILET) @ 0.50 $ ADDRESS 6117 Ns Loma
1 BATH TUB @ 0.50 cITMTemple City TEL No.
SHOWER @ O.SO I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
Z LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
GAS SYSTEM OUTLETS @ 0.50 OF THE RESIDE TI PROPERTY.D/F�q RIBED ABOVE.
SIGNATURE OF _��^
WATER HEATER @ 0.50 PERMtTTE
SLOP SINK @ O.So IN ' ECTION RECORD
FLDOR SINK . @ 0.SO
FLOOR DRAIN @ 0.50_
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 K_ QI� J
HOUSE SEWER @ 0.50Z A✓R-L /�LgG--t
MISCELLANEOUS 6
Q'
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING L`
GAS PIPING ........
'GAS VENT
CESSPOOL @ 1:00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT .
. . I 1.00 GAS TEST
UTILITY CO.NOTIFIEDL.L •7 �� .
TOTAL FEE 5d
/ FINAL