HomeMy Public PortalAbout5227 PAL MAL AVE_Plumbing__ DBSS-17.17 10.99 7BAPPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING,5:p,
JOHN A.LAMBIE.COUNTY ENGINEER ADDRESS _G'
CASSATT D,GRIFFIN,SUP'T OF BUILDING n
LOCALITY
FOR APPLICANT TO FILL IN I NEAREST
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CROSS ST.
OWNER % DISTRICT GROUP �ZONE READY FOR INSPECTION
MAIL
ADDRESS 5 �� ��C.� w/� � 0. I T
IW
,, r INDUSTRIAL
CITY TEL. NO. I '7'�D�/ WASTEAPPROVAL
IF
PLUMBER cd7xd9 INSPECTION RECORD
ADDRESS `sem-IrAlO',,0� -S70-" �j p
CITY EL.NO.61 / D d g
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $•1.00 $
BATH TUB @ $1.00
` SHOWER @ $1.00
` LAVATORY (WASH BASIN) @' $.1.00
KITCHEN SINK @ $1.00
DISHWASHER @ .S1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'$SIGNATURE
UNDER SLAB WORK
iop
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION H07 WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY yy
WITH ALL CQUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING: PLUMBING FIXTURES !i r
I HEREBY.CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE �"�� FINAL
IOHN A.LAMBIE,COUNTY ENGINEER VALIDATIO ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CE. M.0. CASE
MOV 23 3 7.00 0
7BA887-C.E#817 10-87 - }
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDINGq
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ! K.
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY eu�
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50
BATH TUB 1.50 ADDRESS
SHOWER .1.50 CITY TEL. NO.
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS I
DISHWASHER 1.50 CITY TEL.N
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO, CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICpT NO. GROUP NF, CESSED BY
/ �_
LAWN SPRINKLER SYSTEM 2.00 ••�� O C�(ic7• V
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL O
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD V
OUTLETS OVER 30 y
5 PER SYSTEM
Z
Plan check fee 25%of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 00
TOTAL FEE
- APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address. GAS PIPING
GAS VENT
City Tel. N0. HOT WATER HEATER
I HEREBY. 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 GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT'[ 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
L:01F
IDE IN.THE ASO V ESCRIBED RESIDENTIAL PROPERTY. FINAL
NATURE JACK R. ALLEN, SU ER ISI HANICAL ENG''R.
PERMITTEE
mod PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VAL ATION CK. M.0. CASH
D 4.7.5"' r -