HomeMy Public PortalAbout5648 MCCULLOCH AVE_Plumbing__ 76AS67A(CES17A) - G/7iI L ,
APPLICATION FOR PLUMBING PERMIT
� COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING �/Cl n %
hfAKE CHECKS PAYABLE TO: ADDRESS (rJ 1. (i
f HARVEY T. BRANDT, COUNTY ENGINEER
II LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
((� '
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
OWNER
WATER CLOSET
MAIL
BATH TUB ADDRESS
SHOWER CITY m /erjAjJEL. NO.
LAVATORY CONTRACT r)aaca-
I
SINK ADDRESS
DISHWASHER CITY TEL. NO 2
I a
! CLOTHES WASHER STATE 7 � LIC
CLASS C
LICENSE N0.
SWIMMING POOL RECEPTOR
Lao
LAWN SPRINKLER SYSTEM
DISTRICT NO.Q; I GROUP I ZONEr-fRI0jt0SED BY
677�✓ 049
WATER HEATER INDUSTRIAL G
WASTE APPROVAL
GAS SYSTEM OUTLETS INSPECTION RECORD 6�
OUTLETS OVER
5 PER SYSTEM w
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEES
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
HOT WATER HEATER
1HEREBY.ACKNOWLEDGE THAT 1 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND S E OF
CALIFORNIA OR THAT I AM THE GAL OWNER OF, AND TE D TO
RESIDE IN THE ABOVE CRIB �SIOENT4AROPERT
FINAI
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION CK. 0. CASH
PLAN CHECK VALIDATION CK M.O. CASH
.3 0 r
6 19 L2 AUG 12 5 D ? s
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78A887
DBS-173-58 APPLICATION FOR PLUMBING PERMIT
7
DIVISION OF BUILDING AND SAFETY 1
Deportment of County Engineer
County of Los Angeles PBUILDING 5648
p N®McG'ullock
WM.J.FOX,COUNTY ENGINEER- '
CASSATT D.GRIFFIN,SUPT OF BUILD6�I.8
ADDRESS ING ITI
LOCALITY y
FOR PLICANTO FILL IN ' NEAREST
CROSS ST.
OWNE DISTRICT NO. GROUP ZONE READY FOR INSPECTION,
MAIL I Jt
MAIL
INDUSTRIAL I'
CITY TEL.NO, WASTE.APPROVAL
PLUMBER FInCE, INSPECTION .RECORD
ADDRESS .2019 Na Hort P n 0 E,4b8
CITYE1 Monte TEL:NO. GI 41559
LICENSE NO. 11+9236
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $1 00
BATHTUB
SHOWER
LAVATORY ('WASH BASIN) 1.00
1 KITCHEN SINK 1 00
DISHWASHER
LAUNDRY TUB OR TRAY
1100
CLOTHES WASHER.
TOTAL NO. @ 0.80 APPROVALS
GAS SYSTEM OUTLETS @ 1.00 DATE INSPECTOR'S SIGNATURE
1
UNDER SLAB WORK �r J r WATER HEATER @ i.00 I J 1 Y�,�+•� 1•�f ' (.�. +
ROUGH..PLUMBING •LPdJ��j ~, �I`j, �s
PERMIT, g' I 1 00
GAS PIPING
TOTAL FEE 8.100 'GAS VENT
1 HEREBY ACKNOWLEDGE-THAT 1' 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.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANVOR GAS TEST. 14'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANI) STATE OF /� l� /'
CALIFORNIA OR THAT 1 AM TH LEG OWNER OF THE A..BOVE UTILITY CO.NOTIFIED � �/(/ 1,
DESCRIBED RESIDE L P PE
SIGNATURE
OF PERMIT FINAL j! �� f!/ Uli!/yEfi�z�6��
WILLIAM J. FOX.COUNTY ENGINEER VALIDATION R.A.WOOD,CHIEF PLBG.INSPECTOR.
LG-19 7 8�; PIOV 1 1 3. $.00