HomeMy Public PortalAbout6417 LOMA AVE_Plumbing__ 7}A 667,-CE!r#7172-62 -
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER J
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN. SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNERT�
WATER CLOSET $1.25MAIL
l D
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY �+ TEL. NO. T�jjrj%✓�f5i�
LAVATORY 'I.25 CONTRACTOR CAIIIFORNIA POOLS
II SINK 1.25 ADDRESS8806 LAS -TUNAS
DISHWASHER 1.25 CITY SAN, GABRIETL TEL. rhT 6200
LAUNDRY TUB 1.25
REGICONSSTATE
ION NO�` T�J2 COUNTY II
CLOTHES WASHER 1.25 DISrCT NO� GROUP) ZONE P OC ED BY
WATER HEATER 1.50. DO L
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30
pINSPECTION RECORD
i p"o"L T e cu'.
Vf
z
APPROVALS DATE INSPECTOR 5 SIGNATURE'
PERMIT S 2 00 UNDER SLAB WORK 7-'L
ROUGH PLUMBING
TOTAL FEE 13 A GAS PIPING At f f '� L)1�9
67
LRESIDE
BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT f_ 'XV
TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
LL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
G
EBY CERTIFY THAT 1- AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 1 ��
/-
D AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ��
NIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
N,THE ABO DESCRIBED E IDENTIAL PROPERTY UTILITY CO NOTIFIED /IURE RMITTEE S
FINAL
VALIDATION ROBERT A/WOOD �J✓' r
CK M J CASH SUPERVISING MECHANICAL ENG'R
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76 juL 1 '7 o 3.2 5
76A667 (CE-817) - 5/73 ,
APPLICA-TION ,FOR--PLU,MB,I,NGf PE,RM'Ir��--_- '-;—"- ,- —
COUNTY OF LOS ANGELES L
DEPARTMENT OF COUNTY ENGINEER.
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO }gDDRESS
HARVEY T. BRANDT, COUNTY ENGINEER,,,, COCALI
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEARESTIf
pS iY
NUMBER FIXTURE CROSS ST_RE OR ITEM @ FEE �
WATER CLOSET 1.75 OW -
.MAIL,
BATH TUB 1.75 ADDRESS
SHOWER 1,75 CITY - TEL NO -
LAVATORY 1,75 CONTRACT
SINK 1.75 ADDRE /
DISHWASHER 1.7501
CLOTHES WASHER - 1.75 STATE' - LIC �o
LICE NO ' c GLASS r •i
SWIMMING POOL RECEPTOR - 1.75
DISTRICT NO 'GROUP ZONE F CESSED BV
LAWN SPRINKLER SYSTE 1,75
-L J" r
WATER H T 1.75 INDUSTRIAL
WASTE APPROVAL y;
GAS SYSTEM OUTLETS 1,75 - INSPECTION RECORD V '
OUTLETS O ER �i . - - 1r
5 PER SYSTEM •30 - �• a
^�" O
Plan check fee See Reverse -
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS " DATE INSPECTOR 5 SIGNATURE
Plan Check applicant UNDER SLAB WORK,
i f
Name ROUGH PLUMBING,
Address GAS PIPING
CItY Tel, NO GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONHOT WATER HEATER
-
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES • - j _ "'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING '
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSEDAS REQUIRED BY LOS.ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PRj&PERTY FINAL , 'I;j
SIGNATURE
OF PERMITTE '
PERMIT VALIDATION cK M.o CASH'
PLAN CHECK VALIDATION, CK M O CASH
6:,01 01 0 4.7 5 asa