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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDI `r 1_
JOHN ANG AND LAr1Bl ES COUNTY AFETY DIVISION
DRESS V
COLEMAN W JENKINS SUP T OF BUILDING FCALITY
FOR APPLICANT TO FILL IN NEAREST
ROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER r c=
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 CONTRALTO
SINK 1.25 ADDRESS 1_2 ;7
DISHWASHER 1.25 CITY Ci TEL. NO.
SATE I LIC
LAUNDRY TUB 1.25 LICENSE NO y (Q CLASS
CLOTHES WASHER 1.25 DISTRICT GROUP ZONE PROCESS
WATER 1.50
GAS SYSTEM OUTLETS 1'50 INDUSTRIAL CL
WASTEAPPROVAL 0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
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0
H
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W
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N
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND�OR PLUMBING FIXTURES
LICENSED A3 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AN INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESID AL PROPE r UTILITY CO NOTIFIED
SIGNATURE ,,
OF PERM ITT FINAL ��
VALIDATION
CK M O w CASH
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DBS,81779.55 APPLICATIOM F'OR }PLUMBING •PERMIT
DIVISION OF BUILDING AND SAFETY
r Department of County Engineer "
County of Los Angeles
WM.J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
CASSATT D. GRIFFIN, SUPT OF BUILDING NQ /gyp
LOCALITY Pi/YL
FOR APPLICANT TO FILL IN NEAREST
/� CROSS ST.
J �+
OWNER C& fA lor!?4 tV ,0 Pv kees DISTRICT NO GROUP I ZONEI READY FOR INSPECTION
MAIL h
ADDRESS f(
INDUSTRIAL
CITY TEL NO -7-- WASTE APPROVAL
PLUMBER /6 Rey F. TeL� �/
G INSPECTION RECORD
ADDRESS
CITY Ift Gj7` TEL 'NO/r/
LICENSE NO G
NUMBER TYPE OF FIXTURE OR ITEM FEE _
WATER CLOSET (TOILET) $
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO Q O e0 `APPROVALS
/ G DATE INSPECTOR'S SIGNATURE
GAS SYSTEM OUTLETS @ 1 00
ER SLAB WORK
WATER HEATER (u7 1 00 nD UND
ROUGH PLUMBING �y
PERMIT S 1 00
• - I GAS PIPING I
TOTAL FEE D GAS VENT
I IS
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE, IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR,THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED Zb
DESCRIBED RESIDENTIA R ERTY. - y
SIGNATURE
OF PERMITTEE FINAL V
v
WILLIAM J. FOX, COU TY ENGINEER VALIDATION R.A.WOOD, CHIEF PLBG. INSPECTOR
ACO6 O o 91US1 ,M27- 3 9.40
i8A6e7- APPLICATION FOR -PLUM BI NGi"'E9"" MIT_ .�
DBS-17 10-55
DIVISION OF BUILDING AND SAFETY
Department of County-Engineer
County of Los Angeles' BUILDING — 1
JOHN A, LAMBIE, COUNTY ENGINEER ADDRESS U
CASSATT D. GRIFFIN SUPT OF BUILDING
LOCALITY
FOR- APPLI ANT TO FILL IN NEAREST
CROSS ST,
OWNER DISTRICT NO GROUP I Z,j�NE READY FOR INSPECTION
MAIL •�� `r !/C//-i
ADDRESS L
.Q INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
i
M
ADDRES
;-
CITY /� TEL. NO
LICENSE NO. //r(
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00 $
BATH TUB @ $1 00
SHOWER @ $1 00
LAVATORY (WASH BASIN) @ $1 00
KITCHEN SINK @ $1 00
DISHWASHER @ $1 00
LAUNDRY TUB OR TRAY @ $100
CLOTHES WASHER @ $'1 00
WATER HEATER @ $1 00
GAS SYSTEM - @ $1 00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE � O D
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING, PLUMBING FIXTURES
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWN OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY _
SIGNATUREH•� �
OF PERMITTEE FINAL
JOHN•A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A.WOOD, CHIEF PLBG INSPECTOR
CK, H.0 CASH
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