HomeMy Public PortalAbout9166 OLIVE ST_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY �-U B I N
WILLIAM J. FOX, County Engineer
DISTRI T NO. P O .
FOR APPLICANT TO FILL IN A--1 / (L3 Z
PLUMBER VAU FY R01 11 FVARDEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION _� o ^�9
ADDRESS 3 J
BUILDING
CITY ROSREf MpppEAD TEL.No. ADDRESS
A—E 40
COUNTY
E 0. 931Y1 EXPIRES u LOCALITY
NEAREST 007
PERMIT FEES CROSS BT.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) @ 0.50 $i (Q ej
ADDRESS
BATH TUB a 0.50
CITY TEL. No.
SHOWER @ 0.50 �' 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
AND STATEABOVE IS CORRECT
LAVATORY (WASH BASIN) 0.50 C APPLICATION AD AGREE T CCOMPLY WITiL
H A H
INCOUNTY ORDINANCES
KITCHEN SINK 0.50AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
Q C.SO ANGELES COUNTY LICENSE, OR 1 AM THE,LEGAL OWNER
OF THE RESIDENTIAL PROPERT DESCRIBED ABOVE.
GAS SYSTEM-.3--OUTLETS 0 0.50
_ SIGNATURE OF �
WATER HEATER 0.50 �® PERMITTER! oo
SLOP SINK Q 0.50 INSPECTION RECORD
FLOOR BINK 0.50
FLOOR DRAIN 0.50 �
DISHWASHER @ 0.50
DRINKING FOUNTAIN Q 0.60
URI NAL 0.50 .J
a
HOUSE SEWER 0.50 Z
MISCELLANEOUS
O
APPROVALS
DATE, INSPECTORS NAME
ROUGH PLUMBING
GAS PIPING
GAB VENT
CESSPOOL 1.00 CESSPOOL \
SEPTIC TANK: _ SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER
PERMIT 1.00 GAS TEST I
UTILITY CO.NOTIFIED2-1
TOTAL FEE M
.FINAL pp/
76A667 DBS#17 6-5E
76A667 = CE817 5/70 9_565 38 B3
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADaasrsa 9166 E Olive at.
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W:JENKINS. SUPT. OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN(PR NT'OR TYPE —INCERA $T. ROsmead 3314Q 2 cinita Ave.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 7 j 1,60 Travise
BATH TUB .50
MAIL
same -
1
'SHOWER i
so cmTen le City TEL. No.At 76335'.
LAVATORY .50 CONTRACTOR Ter T'i1•e
SINK ADDRESS 5X00 'N Washington Blv:
DISHWASHER .50 CITY 7A 0 TEL. NO.911863
CLOTHES WASHER Aso STATELIC
LICENSE NO.105264 CLASS
SWIMMING POOL RECEI rOR 1.50
1-
DISTRICT NO. GrI Z NE P O
LAWN SPRINKLER SYST M 2.)o
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL 063
GAS SYSTEM OU ETS 1.50. IIISPECYION RECORD
OUTLETSOVER
5 PER SYSTEM .30
O
W
n
rn
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE.$ Z 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING °
Address GAS PIPING
Cit GAS VENT
Y Tel.'No.
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATETHAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
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 I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL P PERTY. FINAL
44 4z 41Z 99.
SIGNATURE ZO .TACK R. ALLEN SUPE
OF PERMITTEE RVISING CHANICAL ENG-R.
m III PERMIT VALIDATIONM.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH -
I Ar- 9 9 9 3 APP.G 9 5 D 4.7 5