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76 A 667.—CE BIAPPLICATION FOR PLUMBING PERM
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER wDvi�v
BUILDING AND SAFETY DIVISION
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JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING LOCAL0
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE OWNER y
WATER CLOSET 150
NAM
BATH TUB 1 50 AODRFSS
SHOWER 150 CITY TEL NO
LAVATORY 150 CONTRACTO vy/ / -L
SINK 1 50 2. - ADD `pv, I IyQ�
DISHWASHER 150 CITU TEL NO�IO/s
CLOTHES WASHER 150 STATE //�,/(� LIC /
LICENSE NO !� T CLASS
SWIMMING POOL RECEPTOR 150
O19TRICT NO GROUP ZONE EBBE
I AWN SPRINKLER SYSTEM 2 DO
NATER HEATER 1 50 INDUSTRIAL U
WASTE APPROVAL 0
GASSYSTEM OUTLETS 150 INSPECTION RECORD
OUTLETS OVER JO d
5 PER SS ST EAI
N
Z
Plan clieck Lel 21% of aboNe SI f rexersP
PLUMHINC PFRMII ISSIIINC FFM 8 2 00
IOT\I FFF
APPROVALS DATE INSPECTOR SSrorvwiuR[
Plan ehf rk applw Int UNDER SLAB WORK Int
Name ROUGH PLUMBING 0
Atld,es, GAS PIPING
GAS VENT
Gq III No
HOT WATER HEATER
HERESY ACKNOWLEDGE IS I HAVE IAN D THIS ATO COMPLY
ANO !TATE THAT THE ABOVE 1[ LAND S AND AOR[[ NE COMELY PLUMBING FIXTURES
PLUM ALL' cou NTY ORDINANCES AND aiwT[ uw[ [[cu unNO GAS TEST
PLUMBING
1 HEREBY CERTIFY THAT I AY PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED Aa R[OVIRED BY LO[ ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTIND TO
REfIDC IN TXE A KRIBCO NTIAL PROPERTY FINAL L 7d
BIGNATU RE JACK R ALLEN, SUPERVISING MECHANICAL ENG R
OF FERMI
PERhllT VALIDATION CK M o Alli
PLAN CHECK VAL DATION CK M O CASH
�r� 7 0 2 5a OCT 2 5 O 5.00-
f
76A667 �E,I)17 6 65
APPLICATION FOR PLUMBING PERMIT
coUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAIABIE COUNTY ENGINEER ADDRESS g2 lv�
COLEMAN W JENKINS SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FELT. IN CRMO 849T
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 11 25 MALL
BATH TUB 1 25 ADDBE88
SHOWER 125 CITY JEL NO
LAVATORY Ips CONTRACTO
SNIR 125 ADDRESS
DISHWASHER 125 crrY TEL NO
LAUNDRY TUB 125 STATE Q � j / a LIC
LICENSE NO Y (P CLASS
CLOTHES WA R 125 a DISTRICT NO GROUP ZONE PROCESSED BY
WATER 150 �pQ� 14A1�7—//
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GAS SYSTEM 1 s0 INDUSTRIAL
OUTLETS o_
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 20 INSPECTION RECORD U
0
H
U
w
z
Z
APPROVALS DATE INSPECTOR 5 SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
HERESY THAT
TH ABO THAT HAVE READ THIa APFLICATIOH GAS VENT
AND STAT[ THAT TH[ ABOVE IS CORRECT AND ADREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMEIING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND END TO
Rm OJE IN THE AFOVE DEE RRl.g. RESIO L PROPS UTILITY CO NOTIFIED
SIGNATURE r
OF PERMI
FINAL
/VALIDATION
o CASH
u{� 3 2 6 9 JUL 5 5 D
3.50-
d
"W' °M I' I'"[D 1 APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY PLUMBING S
a
COUNTY OFF LOS LOS ANGELES
WILLIAM J FOX. CHIEF [NGIN[G
FOR APPLICANT TO FILL IN J— �j-
PLUMBER �. r - ^G.. READY FOR
/ I ' G 1 R BY FIRST INSPECTION DATE ISSUED
ADDRESS
�/ �! /y 9 �/ IJJ
CITY '"- TEL N,:W;,
� IlJ�y�d ADDRESS ! 1/
couwn
LIC NSE NO EXPIRES 30 LOCALITY
NEAREST
PERMIT FEES cwass er p�
NIIYB[w TYF[OF FIMLIq[OR ITCM FEE OWNER Gtr ��^y may"
MAIL
WATER CLOSLT(TOILET) @ O 90 ® ADDRESS F���+
BATH TUB ® 0 SD �S..1
CITY TEL N
SHOWER @ Q 60 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ O BO APPLICATION AND STATE THAT THE ABOVE IB CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK @ O 50 AND STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT 1 POWEBS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 050 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROP[ D CRIBED ABOVE.
GAS SYSTEM OUTLETS @ 050
SIGNATURE OF �µ i�YoLy-Z.K�
WATER HEATER @ O SO PERMITTEE
SLOP BINK @ O 50 INSPECTION RECORD
FLOOR BINK @ 050
FLOOR DRAIN @ Oso
DISHWASHER @ O BO
DRINKING FOUNTAIN @ 050
URINAL @ 050 Q
HOUSE SEWER @ O BO Z
MI ELLANEOUB �_
APPROVALS
DATE INtPCC�Vq• MAM[
ROUGH PLUMBING
GAB PIPING
GAB VENT 7, 2'
CESSPOOL @ 1 DO CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) @ loo SEWER
PERMIT 1 00 GAS TEST
UTILITY CO NOTIFIED B
TOTAL FEE ® �O�
FINAL