HomeMy Public PortalAbout5924 PRIMROSE AVE_Plumbing__ 76A667-CE817 12/59 T MME CRTY
APPLICATION FOR-PLUMBING PIERMIT
_ COUNTY OF LOS ANGELES , ,
DEPARTMENT OF COUNTY ENGINEER.
BUILDI�C� n IE? • MSION BUILDING sy
JOH1V A. LAMBIEr;COUNTY XNGINEER ADDRESS 4/,/,s
WILLIAM A.JENSEN.SUPT OF.BUILDING
LOCALITY
FOR APPLICANT TO FILL IN - NEAREST
_ CROSS ST.
NUMBER FIXTURE OR'ITEM -
OWNER [`
WATER CLOSETy
ADDRESS �d
BATH TUB
CITY TEL N
SHOWER
CO OR
LAVATORY
SING ADDRESS. I
DISHWASHER CITY. TEL. N.
CO R'Sl/lf� STATS
LAUNDRY TUB REGIST ION NO. COUNTY ❑
CLOTHES WASHER 'DISTRICT NO. GRQUPE� P CESS B
WATER HEATER �1 C7 --Sd(+�`
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
V
F
7 -mom Arm, $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER NEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS AMGELES COUNTY AND STATE OF GAS TEST t
CALIFORNIA OR THAT I AM TJIE LEGAL OWN OF THE ABOVE
E
DESCRIBED RESIDENTI R RTY.. UTILITY CO.NOTIFIED• / /
SIGNATURE d� t'-I ����!�/ FjJ ✓'/.��!/��
OF PERMITTE FINAL I yY�/�/V 1-1/01 �
P1v s VALIDATI ROBERT A.WOOD,
SUPERVISING MECHANICAL.ENG'R
U1 Co 2 8 3 3 f"Ay 18 5 0 3.50 �,
76 A 667— CE 817 7-69 - I
APPLICATION FOR : PLQM.BING PERMIT •
.COUNTY OF LOS ANGELES '
DEPARTMENT OF COUNTY ENGINEERf r I
BUMDING AND.SAFETY.DIVISION R>nLnnvG
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS p•'y`fr('°Z��
COLEMAN W. J•ENK'I:NS. SUP'T. O.F BUILDING �s^ I
LOCALITY �GrAl
FOR APPLICANT TO FILL IN PR NT.01 TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNER
MAIL f. t
BATH TUB 1.50 ADDRESSIMF
J
SHOWER 1'.50 CITY t;�: /rG.! . . 1 TEL.N901f,7
LAVATORY ' 1:50" CONTRAC R p3y+r `
SINK 1.50 ADDRESS 'W,� � �
DISHWASHER 1.50 CITY tr
'/.H �•C- rf`' r� TEL.NV,?�.
CLOTHES WASHER. 1.5.0 STATE /� LIC
LICENSE NO: !+r CLASS
SWIMMING POOL.RECEPTOR 1:50
DISTRICT NO. 'IS UP 7ZONE P tOG SSED BY
LAWN SPRINKLER SYSTEM 2.00 J`f �/i a
WATER HEATER 1.50ZIRIALS-WASTE OVA
GAS SYSTEM' OUTLETS A.50 INSPECTION RECORD W
OUTLETS OVER
5 PER SYSTEM .30' LL
Lu
Plan check fee 25%of above. See Teverse. [� i
PLUMBING PERMIT ISSUING FEE 8 f 2 •00
TOTAL FEE !9_0
APPROVALS _DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City. Tel. No. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT-I 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 CAM.PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY,LGS•ANGELES COUNTY AND STATE OF ,
CALIFORNIA OR THAT 1 AMfTHE•,.LEGAL OWNER OF AND INTEND TO. . _.
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPBRTY.,., FINAL '
31GNATURE JACK R:A•L'LEN SUPERVISING MECHANIC per•'
OF PERMITTEEI /��` + s
PERMIT VALIDATION CK. M.O. CASH_
PLAN CHECK VALIDATION CK. M.O. CASH