HomeMy Public PortalAbout6236 LOMA AVE_Plumbing__ 7GA667 (CE-817),- 1/75 '
APPLI ATION ' OR PLUME�Ml G PERMIT {�
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DEPARTMENT OF OUNTY ENGINEER �J
BUILDING AND SAFETY DIVISION BUILDING 3
MAKE CHECKS PAYABLE TO ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY 0�i
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM @ FEE OWNER Q
WATER CLOSET 200
MAIL
BATH TUB 200 ADDRESS �—
SHOWER 200 CITY TEL NO.
LAVATORY 2 00 CONTRACTOR
SINK 2 00 ADDRESS
DISHWASHER 2 00 CITY z� / 'TEL NO —�
CLOTHES WASHER 200 STATfLICENSE NO '// Q CILASS C .
SWIMMING POOL RECEPTOR 2 00
DISTRICT NO GROUP E Pfi CESSE BY
LAWN SPRINKLER SYSTEM 200 �& _ (
WATER HEATER 200 INDUSTRIAL
/, WASTE APPROVAL �
GAS SYSTEM OUTLETS 200 �(/ INSPECTION RECORD
OUTLETS OVER .30 O
5 PER SYSTEM
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Ct
N
Z
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Plan check fee See Reverse I
PLUMBING PERMIT ISSUING FEE $ 00
TOTAL FEE
APPROVALS DATE INSPECTOR 9 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
I Address GAS PIPING
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 GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
o LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I A THE LEGAL NER OF, AND INTEND TO / ..
RESIDE IN THE ABOVE DE C (BED RESID IAL PROPERTY. FINAL
SIGNATURE �..
OF PERMITTEE
PERMIT VALIDATIONC: M.O. CASH
PLAN CHECK V DATION CK M O. CASH
gb'[:-'APP 19 5 0 7:5 0 &�a
76AG67-CE#817 5/63
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT-OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN o NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 a1 S!7
MAIL
BATH TUB 1.25 AA 5 ADDRESS
CITY TEL. NO.
SHOWER 1.25 a �!
LAVATORY 1.25a tJ O CONTRACTOR
nJ-
SINK 1.25 / of s ADDRESS
DISHWASHER 1.25 a 5 CITY TEL. NO. _ d by
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
COUNTY ❑
REGISTRATION NO.
CLOTHES WASHER 1.25 DISTRICT GROUP ZONE CESSED BY
WATER HEATER 1.50
GAS SYSTEM a OUTLETS 1.50 v INDUSTRIAL d
WASTE APPROVAL �
OUTLETS OVER PER SYSTEM .30 /INSPECTION RECORD
W
CL
�vl Z
JAPQROVAL __4D TE INSPECTOR S SIGN�IT
PERMIT $ 2 00 UNDER SLA'B'WORK I
ROUGH PLUMBING
TOTAL FEE (o 1,261 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL
COUNTY ORDINANCES AND STATE LAWS REGULATINGPLUMBINHOT WATER HEATER 4 Y
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ���{ _
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOVE DES RIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED ° (} �
SIGNATURE
OF PERMITTEE
FINAL
LIDATION ROBERT A WOOD
CK M O CASH SUPERVISING MECHANICAL ENG R
L- o 8 5 5 9 ID I Iffy 7 5 D 65
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