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76A667 (SCE-817) - 5/73
APPLICATION FOR PLUMBING P&RMIT 5
COUNTY OF LOS ANGELES
DEPARTMENT OF,COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING //Q � l �`
MAKE CHECKS PAYABLE TO ADDRESS (76 L.( D
HARVEY T. BRAN DT, COUNTY ENGINEER LOCALITY CR 0
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER, FIXTURE OR ITEM @_ FEE CROSS ST. .
OWNER.
WATER CLOSET 1.75 MAILy�
BATH TUB 1.75 ADDRESS 6 )G n/� b
SHOWER 1,75 CITY R CPC TEL NO y —
LAVATORY 1,75 CONTRACTOR ? Ig C_
SINK 1.75 ADDRESS d v^
DISHWASHER 1.75 S CITY C ;TEL NO _ O 0
CLOTHES WASHER 1.75 STATE /� 9 9 LIC
LICENSE NO o�I�� 1 a CLASS
SWIMMING POOL RECEPTOR 1,75
DI ICT NO GROUP CESS BY
LAWN SPRINKLER SYSTEM 1,75 '
WATER HEATER 1,75 INDUSTRIAL
WASTE APPROVAL >
GAS SYSTEM OUTLETS 1.75' O
INSPECTION RECORD V
OUTLETS OVER 30
5 PER SYSTEM
O
U
W
0-
Plan
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Marti@ ROUGH,PLUMBING '
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 �7„ .r_`?i 7h PJ
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 PROPERTY
FINAL 3"7 ' 0(r�'"��.���
SIGMA TU RE
OF PERMITTEE ...1/J 000"`�����p---••��� '
PERMIT VALIDATION CK M O CASH `
PLAN CHECK VALIDATION CK M.O. CASH
76A687,CE#817'9/63
APPLICATION FOR PLtJMEING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER,
BUILDING AND SAFETY DIVISION AD 7N 660E Lemon
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY Tem le Cit
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE " - '
by
2' WATER CLOSET $1.25 2 50 MAILOWND. C°. �!shl
1 BATH TUB 1.25 1 25 ADDRESS 3371 N Corrida Dr
CITY, COV,1n8 TEL. NO.
1 SHOWER 1.25' 1 25
2 LAVATORY 1.252 5 - CONTRACTOR Valley Plumbing Co:
1' SINK 1.25 1 25 ADDRESS W. Fleetwood Place
1` DISHWASHER 1.25 1 25 CITY Glendora TEL. NO. Ed"51293
CONLAUNDRY'IUB F 1.25 REGISTARAT ON NO. 209431 _ COUNTY STATE p
1 CLOTHES WASHER " , 1.25 1 25 DI ICT ZONE PRGCESSED BY
1 WATER HEATER 1.50 1 50
1.50 1 50 INDUSTRIAL
GAS SYSTEM OUTLETS WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
0 .
U
W
CIL
' Z
Iq
AP;06 DATE .INSPECTORpS SIGNATUgE
PERMIT $ 2 00
UNDERASL-Aa,WORK
�
ROUGH•PLUMBING _
TOTAL FEE 16 25 GAS PIPING 'i�
I HEREBY AC KNOWLC DGE THAT I HAVE READ THIS APPLICATION � •
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING° HOT WATER HEATER Q
n
I HEREBY CERTIFY THAT I 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 0114ER.OF,AND INTEND TO / A
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY
UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE + ,r
FINAL 9-
ALIDATION- ROBERT A WOOD -
cK M 6 CASH SUPERVISING MECHANICAL ENG'R -
76A667 (CE-817)-4/72 OBING
APPLICATION R 'PL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO. BUILDING
ADDRESS 9660 E. Lemon N-<--
HARVEY
�
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST `
r CROSS ST
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1,75 OWNER Keith K. amane
MAIL
BATH TUB 1.75
ADDRESS 9660 B. Lemon
SHOWER 1,75 CITY Arcadia TEL. NO X47_7187
LAVATORY 1.75 CONTRACTOR Trane H C C
SINK 1.75 A61RESS 2oi4 N. Peck d
DISHWASHER 1.75 CITY_ So,. 1 Mo t e TEL NO 579-7982
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO. 26509 CLASS C-20
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO GROUP NE F CESS D BV
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1.75 INDUSTRIAL a
WASTE APPROVAL
1 GAS SYSTEM OUTLETS 1.75 1, 75 INSPECTION RECORD V
OUTLETS OVER 30 O
5 PER SYSTEM
CAJ
W
LL
VJ
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE I 4t75
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPINGoD�
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
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIA PROPERTY
FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK M o CASH
PLAN CHECK VALIDATION CK M.o CASH
1 4 N JUL 19 5 D �
4.7 5At�