HomeMy Public PortalAbout4965 PERSIMMON AVE_Plumbing__ 76+A 6.67—CE 817 B/68
;APPLICATION FOR PLUPViBING P MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ♦� SIBS
,.BUILDING AND SAFELY DMSION iIn
DDADESS `
JOHN-A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY _ CJ
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE. Q
OWNER
WATER CLOSET
IL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY r==
TEL. NO. 12
LAVATORY1. 0
CONTRACTOR '
SINK 1. 0 ADDRESS
DISHWASHER 1 50 ` CITY STATE L AE TEL.NO.
CLOTHES WASHER. 1 50 / 5 LICENSE NO. �. CLASS
SWIMi\tING POOL RECEPTOR 1,50 DISTRICT NO. GROUP ZONE ESSED BY
ooT
LAWN SPRINKLER SYSTEM 2,
'ooT00 �-
WATER HEATER 1 50 � .1 INDUSTRIAL
wAsrE APPRovAL o
GAS SYSTEM OUTLETS .50 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30 a
C40
Z
Plan check fee 25% of above. See reverse..
PLUMBING.PERMIT ISSUING FEE S 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check Applicant UNDER SLAB WORK
Name ROUGH PLUMBING - ) / �� _rrs•/
Address GAS PIPING
GAS VENT I
City Tel.,No.
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 VO T
PLUMBING.
ALA
THAT 1 AM PROPERLY RE61STERED 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 DE RIDER RESIDENTIA PROPERTY. NAL
SIGNATURE JACK R. ALLEN, SUPERVISI G M HANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATIONt. CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
,-:.�.
2.0 4 59 -AW 23 5 .a 8.2.;5 N a
76A667 CE917&60 /
APPLICATION FOR PLU RING PERMIT �
DEPARTM NT OF COUNTY ENLGINEER �] y/� ,�1
BBUILDING
JOHNIA.L.AAMB E.COUNTY ENGINEER SIOi ADDRESS =—�t P '1 I ! o N S
WILLIAM A.JENSEN.SuP'T OF BUILDING �
LOCALITY 1 0 c
ME
FOR APPLICANT TO FIM IN NROSS NEAREST .
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
D RATE TUR ADDRESS
A SHOWER CITY TEL NO.
LAVATORY CONTRACTOR MONTEREY PARK PLUMBING CO. Wa, =
d snas ADDRESS 4.10 SO. GARFIELD • AT 22604
CITY
- MONT6-jLPh8!, CALIFORNIA
DISHWASHER
CONTRACTOR'S STATE
I LAUNDRY TUB REGISTRATION NO. COUNTY
CLOTHES WASHER DISTRICT NO. GRO NE P ESSED BY `
WATER HEATER
w SYSTEM INDUSTRIAL r
WASTE APPROVAL
II1$PECTIONRWORD
1'a�-i�`C'��� ../'j.i,)R. ✓i .:.I - ter, j oG
O
rLGi
..
+
W 01.00 PER ITEM I
/0 OR FIXTURE $ /0 APPROVALS r �. DATE INSPECTOR'S SIGN41TURE
PERMIT2 00 UNDER 8L-PiB'WH:
OR -
TOTAL FEE ROUGH PLUMBING
GAS PIPING t
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION fir!
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT e I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER Jr-IA PLUMBING. ••
I HER CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES vC /J ell
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST c3 ri. A
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY
UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTERFINAL fb AllIyj
pr �:
AMATION ROBERT W W OD.
M.O. CAN SUPERVISING MECHANICAL.ENG'R
.�. , ,,6:0-:L- i ' tiEC 12 5 D :L2.00