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76A667-CE 4'817 2-62 -
APPLICATION FOR •PLUMBI G PERMIT''
COUNTY-OF-LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING•AND SAFETY DIVISION BUILDING c .
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ( (!
WILLIAM A.JENSEN, SUPT.OF,BUILDING
LOCALITY'
FOR APPLICANT TO FILL IN CROSS TT. ;G,
NUMBER FIXTURE OR ITEM EACH. FEE OWNER Sc
WATER CLOSET $1.25 - t ilr,o
MAIL
BATHTUB •, '. 1.25- ADDRESS'_. _ .
SHOWER 1.25 CITY P!✓� f CC TEL. NO.
Z .LAVATORY 1.25 f� CONTRACTOR ��� 5
SINK 1.25 +�Sr- ADDRESS A/ �CLp //c L
DISHWASHER 1:25 crii ! (►�� TEL. NO.E'p-71f'06.•
LAUNDRY TUB 1,� CONTRACTOR'S: i STATE
REGISTRATION NO. ��7•SS-�j•.` : •. COUNTY p„
CLOTHES WASHER 1.25 (. $S� DISTRACT NO. GROUP NE P OCES D
f WATER HEATER 1.50 1 5`Q' —
GAS SYSTEM_ OUTLETS- 1.50 INDUSTRIAL..
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM '.90 ?'
INSPECTION RECORD
No
y....
/
APPROVAL'S' DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK /. r
ROUGH PLUMBING
TOTAL FEE
•� � � GAS PIPING •�i .:;U�•
LEBY ACKNOWLEDGE THAT:i•HAVE READ THIS APPLICATION v
TE THAT THE ABOVE IS CORRECT.AND AGREE TO COMPLY GAS VENT
LL COUNTY-ORDINANCES AND STATE LAWS REGULATING ,.HOT WATER HEATER G. mv
EBY 'CERTIFY THAT 1 AM PROPERLY- REGISTERED AND/OR' PLUMBING FIXTURES �D AS REQUIRED BY LOS ANGELES COUNTY AND STATE CFGAS TEST. ���. �aa/i.'fs���.,,.p��,, 'NIA OR THAT I AM THE LEGAL OWNER OF.AND INTEND TO w: 'fi�!� �
IN.THE ABOVE DESCRIBED REST NTIA pROPERiY. UTILITY CO.NOTIFIEDURERMITTEE - FINAL ����� '•..�_ -,��� ,-
ALIDATION ; ROBERT A!WOOD. Y
CK Wo. :CASH. SUPERVISING MECHANICAL ENG'R
L��Lo $ 0 4 5 5EC .7 5 D 1 3.7 5N. .
78A867-CE.#817 2-62
APPLICATION FOR PLUMBIG PERMIT
COUNTY OF LOS ANGELES 6 S
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUNG
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEARESTST. +
NUMBER FIXTURE OR ITEM EACH FEE CROSS
OWNER r
WATER CLOSET $1.25 MAIL
BATH TUB 1,25 ADDRESS DQ
SHOWER 1.25 CITY TEL. NO.
awl
LAVATORY 1.25 CONTRACT
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL.NO.
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑❑
REGISTRATION NO. COUNTY
CLOTHES WASHER 1.25 D T ICT NQ/ GROUP ONE R OCE D Y
WATER HEATER 1.50 �uQ
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD Off.
u
U
U.
W
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 5 2 00 UNDER SLAB WORK
TOTAL FEE _ ROUGH PLUMBING
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
PLUMBING. HOT WATER HEATER •'`�
1 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 DESCRIBED RESIDENTI L PROPERTY. UTILITY CO.NOTIFIED `
SIGNATURE ZZ
r /
OF PERMITTE FINAL �f°�
ALIDATION/" ROBERT A!WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
L11,Lo
8 a, 6 3%c..' DEC 7 5 D 3.5 O Ncq