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APPLICATION FOR PLUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER NG
BUILDI
BUILDING AND SAFETY DIVISION BUILDING X81 Primrose
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUP'T OF BUILDING
LOCALITY Temple C1t7
FOR APPLICANT TO FILL IN SOS T. Las Tunas
NUMBER FIXTURE OR ITEM EACH FEE
OWNER John Ton i on
WATER CLOSET $1.25 MAIL -
BATH TUB 1.25 ADDRESS same
SHOWER 1.25 CITY Same TEL.NO. hjt3-�*
LAVATORY 1.25 CONTRACTOR 'Pac•f C Installers
SINK 1.25 ADDRESS 1-0920 E. Grand
DISHWASHER 1.25 CITY 2: .D e City t TEL. NO. 443-6905
REGISTRATION NO. 211898 STATE �
LAUNDRY TUB 1.25 COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NA.I GROUP ZONE PROCESSED BY
WATER HEATER RenlaCeme .40 < �J T
1.50 INDUSTRIAL
GAS SYSTEM OUTLETS WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 u
INS$ECTION RECORD
IVl Y
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 140 GAS PIPING
e
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
9 '
i HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES �� Y
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST J f
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERT UTILITY CO.NOTIFIED f f
SIGNATURE /` it •/,rn��
OF PERMITTEE FINAL
VALIDATION ROBERT/d.WO
OD V
cK M.O. I CASH SUPERVISING MECHANICAL ENG'R
Lliuo 1 a 8 .9,a t;'r211 :D 0 3.5 0
76A66^ DBS 17 11-So APPLICATION FOR PERMIT
' AR 'COUNTY
OF LOS NG AND SAFETY PLUMBING
COIINTY OFF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
58R APPLICANT TO FILL IN DISTRICTRO P ONE PERMITO.
PLUMBER RECEIVED BY READY FOR DATE ISSUED
SNSPECTION `1
ADDRESS ac/� //nom/ (!A W FIRST I� FIRST
CITY - / Q�j lo TEL.No ® NG
'ell ADDRBUILDESS�ffIS WOO y�y/
BOUNTY NO. EXPIRES► bG� LOCALITY � lTO C0/ d
NEAREST /v
PERMIT FEES CROSS ST.
/
NUMBER TYPE OF FIXOWNER J• ®f'{QTURE OR ITEM FEE ® /�
ADDRESS g 7 b fl `i"�/
A/6 -Ole- q-,oAe S
WATER CLOSET(TOILET) � 0.50 $ ®A� m�
® BATH TUB @ 0.5,0 ,5® CITY y- TEL N
SHOWER 0 O.SO 945 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 ,rp AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0 0.50 p ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
BAB SYSTEM OUTLETS 0.50 �® OF THE RE IDE
PROPER] D SCRIBED ABOVE.
SIGNATURE OF I� Y
® WATER HEATER @ 0.50 8 PERMITTEE
SLOP BINK 0 O.So INSPECTION RECORD
FLOOR SINK 0 0.50 oldq Ae'pw/3"Ala ` 4e�
FLOOR DRAIN � 0.50 . F �L' C� / 9'
DISHWASHER 0 0.50 y _
DRINKING FOUNTAIN 0 0.50 �7��j �
URINAL Q 0.50 _d D 1 B V5 �/a J
HOUSE SEWER 0.50 Z
� / D
MISCELLANEOUS tQQ/9 &/2f/L, OFbC
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
A� 141
GAS PIPING
GAS VENT
CESSPOOL 1,130 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER O /
PERMIT 1.00 GAS TEST
Iv b
/� UTILITY CO.NOTIFIED'
TOTAL FEE !s ZV So
FINAL �,,�j.�,II�b• � F S
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