HomeMy Public PortalAbout10662 LORA ST_Plumbing__ 76A667(CE-817)- 5/73
-� _ ORPERMITAPPLICATIO F
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ,
MAKE CHECKS PAYABLE TO: ADDRESS z
HARVEY T. BRANDT, COUNTY ENGINEER' LOCALITY
,FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS-ST.•
NUMBER FIXTURE ORJTEM @ FEE
_OWNER ter•
WATER CLOSET "1.75 �,0
MAIL ' ry
BATH TUB 1.75 ADDRESS
SHOWER1.75 CITY .�/ ' Q+' TEL. NO. ��
.LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY TEL INO.
CLOTHES WASHER 1.75 STATE V LIC _
LICENSE NO. CCASS•'
SWIMMING POOL RECEPTOR 1.75
DI CT NQ ,GROUPNE OCESS .BY
LAWN SPRINKLER SYSTEM 1.75 R yJ- -,
.WATER HEATER 1.75 INDUSTRIAL
AST (/
WE APPROVAL a
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER
5 PER SYSTEM •30 0
d
• rn
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
' TOTAL FEE ••
APPROVALS DATE I'NSPECTOR'S SIGNATURE
Plan the applicant UNDER SLAB WORK .Z7:
Name - ROUGH PLUMBING v
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
PLUMBING. GAS TEST
ID
CERTIFY"THAT i AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED '
LICENSED AS REQUIRED BY. OS ANGELES COUNTY AND S•TATE.OF ••
CALIFORNIA OR THAT 1 AM E LEG L 0 NER O -AND INTEND TO '
RESIDE IN THE ABOVE DESC I EO RE DE AL P E Y. FINAL
v
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION Cii. M.D. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
6. 8 9 X.NOV 12 5 °D' ' . .4-.7 5 A
78A8.87A(C,E817A)e.-8/78PLICA
r e _ 1 ®• ¶ •
T.
COUNTY OF LOS ANGELES
-DEPARTMENT OF COUNTY EN..GINEER
BUILDING AND.SAFETY DIVISION'
MAKE CHECKS PAYABLE TO. BUILDING,
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY :rEW P LVr �
FOR APPLICANT TO.FILL IN (PRINT OR TYPE1 NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM FEE OWNER.
-r*Ea
-WATER CLOSET
MAIL /
BATH TUB D ADDRESS k
SHOWER CITY TEL..NO.
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER
CITY. TEL. NO.
CLOTHES WASHER STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR
DISTRICT NO. GROUP NE CESSED 8Y
LAWN SPRINKLER SYSTEM
• -o� �.L �r
WATER HEATER INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS INSPECTION RECORD
OUTLETS OVER AU
5 PER SYSTEM
0
F
W
tntn
Z
Plan check fee See Reverse /
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
t Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING!
City Tei. NO. GAS VENT '
HOT WATER HEATER
I HEREBY.ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE,IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES �•
WITH ALL COUNTY. ORDINANCES' AND STATE LAWS REGULATING '
PLUMBING. GAS TEST - -
I HEREBY 'CERTIFY THAT I AM PROPERLY REGISTERED AND%OR 1. UTILITY CSO. NOTIFIED
LICENSED AS RE0UIREO BY L 'ANGELES COUNTY AND &TATE OF
CALIFORNIA OR THAT 1 AM LEGYMON
W ROF�, A D1 TEND TORESIDE IN TH'E'ABOVEbESCR RETI PRO E TY. FINAL
SIGNATURE
OF PERMITTEE
r. PERMIT VALIDATION. . CK.- M.o CASH
PLAN CHECK_VALIDATION CK. M.O. .CASH
/12
76A667-C,EBIAB 59 _
APPUCAT�PN FOR PLUMBRN PARM�I_T
COUNTY OF LOS ANGELES
DEPAR"TBUM OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION RUILDRYG _
IOHN A.LAMBIE, County es ADDRESS. ' 17
CASSATT D. GRIFFIN,Sup t of$wilding ° LOCALII7 / ?
x � Y
FOR APPLICANT TO FILL IN NEAREST
CROSS ST..
NUMBER FIXTURE OR ITEM
ti OWNER
WATER CLOSET .MAIL
BATHTUB
ADDRESS
3 CITY TEL NO.
SHOWER •UPB S NUMBING SERVICS
' CONTRACTOR LAVATORY ®. balilwill Avenue '
' SINS ADDRESS
DISHWASHER CITY 9 �' 11 aN0° 0 - t3 _
CONTRACTOR'S STATE,
LAUNDRY TUR REGISTRATION NO. COUNTY
_ o _
CLOTHES WASHER' D1ST$1Gf NO. GROUP TZONEPR D Y
WATER HEATER r �/.0 A' �.
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
-INSPECTION'RECORD
e .
.1S�A /!�T G/!%/t•,b�_r .19.E v hre �. /C'a•.7`�••� a
1
0.110/ Yllkd� a447 -tit
• - ,.�� �� �.�C s �,C'.�=9 tires'• ..nNJ.��
n 4P 41. PER
ORFDCTURE d°7 '
�/ ' APPRO LS DAT INSPECTORS SJ, NATURE
r PERMIT $ Q R
OO UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING r I
GAS PIPING t
I HEREBY ACKNOWLEDGE. THAT I HAVE ,READ THIS.APPLICATION'
AND-STATE. THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY ji GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 9 HOT WATER HEATER
'PLUMBING. "
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
LCALIFORNIA,OR THAi 'I AM THE LEGAL OWNEROF 7HE ABOVE GAS TEST IDENTIAL PROPERTY. UTILITY CO.NOTIFIED.RME
" FILIAL
®p AI.IDATION ROBERT A. OaD,
Og, M;O, OA88 SUPERVISING MEOHmicm,ENG'R
rbo 4 4 8 &" Ails 4 5 Q 4.00