HomeMy Public PortalAbout9129 OLEMA ST_Plumbing__ 7GA667C (CE-9178) -9/75 �.
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING /
NUMBER FIXTURE OR ITEM @ FEE ADDRESS �f
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER
- ADDRESS
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CITY TEL. NO.
STATE LIC
WATER HEATER LICENSE NO. CLASS
DISTRICT NO. GROUP O SED BY CD
GAS SYSTEM OUTLETSDIJ
]ZONE�, I /
OUTLETS OVER
5 PER SYSTEM v
WASTE APPROVAL Lu
d
INSPECTION RECORD rn
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $ —�
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel NO. GAS PIPING
IHEREBY ACKNOWLEDGE THAT I 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 AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RES DE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SI G NA TU R E '�—
OF PERMITTEE;;jj�����_ FINAL 'Z•e���
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. (CASH
34 Oro-SEP 24 15 D 7.5 "
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76 A 667 - CE 617 7=69 �E/s/ p
APPLICATION FOR PLUMBING P =RMIT
COUNTY OF LOS-ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION B
UILDING
JOHN A. LAMBIE. COUNTY ENGINEER DDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING OCALITYNEARI
FOR APPLICANT TO FILL IN(PRINT OR TYPE) NE
ROS SS ROSS ST.
NUMBER FIXTURE OR ITEM rEACH FEE
OWNER -
WATER CLOSET ADD BATH TUBADDRESSSHOWER CITY y TEL.NO
LAVATORY 1.50 CONTRA OR
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY f TEL.NO N't/.I
CLOTHES WASHER 1.50 STATEL
rC
LICENS O: XP �r CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00 Qg
WATER HEATER 1.50 5 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETSOVER Q
5 PER SYSTEM .3.0
to
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEES 1 2 100
TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
—Address GAS PIPING
GAS VENT
City. Tel. No. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION PLUMB ING.FIXTURES
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 'GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR .UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE D CRI RESIDENTIAL PROPERTY. FINAL ,�d
SIGNATURE + JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE y
PERMIT VALIDATION (f5> M.O. CASH.
PLAN CHECK VALIDATION CK. M.O. CASH -
1 Ar- 010 49 APFI 3 0 5 D .3 5. 0