HomeMy Public PortalAbout9716 OLIVE ST_Plumbing__ 7&&W-C1'817 6-60
APPLICATION FOR PLUMBING PERMIT . �
DEPART OF COUNTY ENG EER ;
SUII.DING AND SAFETY D1VlSION BUILDING /}
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN,SUPT OF 13UILDINCI
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
4 CROSS ST.
NUMBER FIXTURE OR ITEM OWNER )
WATER CLOSET J �F `
BATH TUB ADDRESS
CITY f ✓cTEL.NO.
SHOWER -
LAVATORY CONTRACTOR .
r
DISHWASHER cETY ' TEL NO�
CONTRACTOR'S n n STATEI
LAUNDRY TUB REGISTRATION NO. / / S COUNTYEl
CLOTHES WASHER DISTRICT N GROP
V Z P BY Y
WATER HEATER r C/ Q�
4
GAS SYSTEM 11MUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
01
� �
0 $1.00 PER ITEM OR
OR FDC[UBE $ U' APPRO ALS DATE, INSP TOR'S SIGNATURE
PERMIT $ 2100 UNDER.$ ORK 11
TOTAL FEE ROUGH PLUMBING l=!� ?_ ,�ti,�i/ a.
GAS PIPING ` -•�
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. v
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES .!J
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE.OF GAS TEST " s�. �.
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIA PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE I 1 A e
OF PERMITTE G� �7s
FINAL !amu``✓
�v VALIDATION ROBERT A.WOOD,
cK.. e.a CASR SUPERVISING MECHANICAL ENG'R-
UCo8 5 2 8 JiP3 14 5 0 5.0 0 m
76AG 67A(tE817A) - 8/76
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS =710111711'%�6-rle
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST //7� 7'
NUMBER FIXTURE OR ITEM @ FEE CROSS ST. CSO es
WATER CLOSET OWNER MAIL AA
BATH TUB ADDRESS 77/6 ®li V� s24-
/ SHOWER D CITY G TEL. NO'.28 jp lZ95"
LAVATORY CONTRACTOR J�Y
SINK ADDRESS9/23f
DISHWASHER CITY �j{/L/��� TEL. N026-_?Io
CLOTHES WASHER STATEL CENSE NO.3,2 J / ®7 CILASS-5
SWIMMING POOL RECEPTOR
DISTRICT NO. GROUP ZONE OCYtOD BY
LAWN SPRINKLER SYSTEM d-! I
r
" WATER HEATER INDUSTRIAL
WASTE APPROVAL.
GAS SYSTEM 3 OUTLETS 2 INSPECTION RECORD
OUTLETS OVER 0
5 PER SYSTEM
W
661
ul
N
z
Plan check fee See Reverse
-PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR'S. SIGNATURE
Plan check applicant UNDER SLAB WORK
Name "'J- _ ,_4& ROUGH PLUMBING
Address .S �7'6,0V4.1 GAS PIPING
City (d� Tel. No.,2g GAS VENT
HOT WATER HEATER
IHEREBYAdkNOWLEDGE THAFr 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURE$
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST q
PLUMBING.
I HEREBY CERTIFY THAT I AM P PERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS AN LES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LE L OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE SDE RISE R IDENTIAL PROPERTY. FINAL
SIGNATURE ��� e
OF PE
PERMIT VALIDATIONcK. M.0. CASH
PLAN ALIDATION CK .O. CASH
0 6 611-NOV 1 5 D �' 2 5.5
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