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APPLICATION FOR PLU°MB:ING ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Y
BUILDING AND SAFETY DMSION RIIILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 6421
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY To C.•
FOR APPLICANT TO FILL IN PR NT OR TYPE CgOSB ST. Q
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNER V.,, Kennicott
MAIL
BATH TUB 1.50 ADDRESS as above
SHOWER 1.50 CITY T.C.T�r �+ TEL.N0447-4416
LAVATORY 1.50 CONTRACTORYY• E. Graham
SINK 1.50 ADDRESS 127 Las..Tunas Dr
DISHWASHER 1.50 CITY T.C. TEL•NO2S6-9293
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. 104466 CLASS C-36
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP
ZONE ESSED BY
LAWN SPRINKLER SYSTEM 2.00
WATER HEATER replace 1.50 1 750 INDUSTRIAL� PROVAL Z
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORDa.4
0
OUTLETS OVER g '� , �I ,r `
5 PER SYSTEM •30 i G /
"A44
Z
Plan check'fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE. S 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
CLWITH
Tei.. NO. HOT WATER HEATER
EBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ATETHAT THE:ABOVE 18 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
LL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
G.EBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
D AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
NIA OR THAT 1 AM THE LEGAL OWNEOF,AND INTEND TO
IN,THE ABOVE DE8 RIBED RESIDEN PROPERTY FINAL
URE JACK R. ALLEN, SUPERVISIN . CFIA'NICAL EN'G'R.
RMI
PERMIT VALIDATION C.K. M.O. CASH,
PLAN CHECK VALIDATION L'K. M.O. CASH
] Ar.,3 2 0 9% D031 5 D 3.5&-
cu
76A667-CE#617 2-66
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APPLICATIONeRL .ING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDDYG ` 1
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS. L!' / A 3 / O
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS:ST.
NUMBER FUTURE OR ITEM EACH FEE
OWNER'.
WATER CLOSET $1.25
BATH TUB 1.25 DRESS .d..i
SHOWER 1.25 -ITY TEL. NO
LAVATORY 1.25 CONTRACT•R
SINS 1.25
ADDRESS ' 9
DISHWASHER 1.25 CITY TEL. NO' -gW
LAUNDRY TUB 1.25 STATE �OJ,
,J LIC
LICENS / CLASS
CLOTHES WASHER 1.25 DISTRRIICTN GROUP ZO E PRO ESSE BY
WATER HEATER 1.50 �5` .�� �
GAS SYSTEM OUTLETS 1.50: INDWASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .90 CD
INSPECTION RECORD
oc
t-e, o
LLI
93-
APPROVALS
APPROVALS DATE INSPECTOR'S 516NATURE
PERMIT $ 2 . 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE y GAS PIPING
1 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
'
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER.OR AND INTEND TO
RESIDE IN,THE A=IDENTIAL PROP Y. UTILITY CO.NOTIFIED
SIGNATUREOF PERMITTE
FINAL
VALIDATJGN JACK R.ALLEK
CK. M.O CASH SQPERVISING MECHANICAL ENG'R.
U;o.g 1 0 a%a 15 5 D 325-
a
76A667-CE..#817 5-61• C '
APPLICAT.I'ON FOR PLUMBING PERMIT
COUNTY OF LOS r-47Q,11
.DEPARTMENT OF COUNTY ENGII�iEER
BUILDING AND SAFETY DIVLSION BUILDING
JOHN A. An ?
COUNTY ENGINEER ADDRESS 7 ^/` A-e.,EF
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY e—i r Y .
FOR APPLICANT TO. FILL IN CNEAREST
ROSS ST.
NUMBER FIXTURE OR ITEM- OWNER
WATER CLOSET
�
S Vi&A
BATH TUB � -
CITY TEL NO.
SHOWER
LAVATORY commmlr8 x , fLe:�
ADDRESS
SIIm
DISHWASHER clrx 4A i4. TELNO.Aee—//,P6-3
CSTATE
LAUNDRY TUB ' REGISTRATION NO. Cou Y
CLOTHES WASHER DI8TRICT NO. GROGE P CESSED BY
WATER HEATER 1 AN
O
DUSTRIAL
GAS SYSTEM WASTE APPROVAL V
a�16PBCTION RECORD. C
' v
ra SIAO PER ITEM
OR FIXTURE $ I APPROVALS 0,AT
# fifNtECTOR S SIGNATURE
PERMIT - 5 2100 UNDER SLAB WOR 'F !
TOTAL FEE ROUGH PLUMBIN _ V
GAS.PIPING
1 HEREBY ACKNOWLEDGE 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
PLUMBING. HOT,WATER HEATER,
-
'
1 HEREBY CERTIFY TH 1 M• PROPERLY 'REG RED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRE
Es. AND STATE OF ee
CALIFORNIA OR THA T AL OW OF THB ABOVE GAS TEST - f.
DESCRIBED RESIDEN OF ' UTILITY CO.NOTIFIED
SIGNATURE
OF FERMI" T FINAL Ian 14VII -",
ATION ROBERT�43CHAN16AL
o6G/l
EK. M.o. CASH SUPERVISINENG'R
�rll,o 5 4 9 7:3 'IAY ; 1 5 D 3.25-