HomeMy Public PortalAbout5926 1/2 PRIMROSE AVE_Plumbing__ 76 A 667—CE 817 468 =s%�
APPLICATION FOR PLUIMBI G PER T
COUNTY OF LOS ANGELES u
DEPARTMENT OF COUNTY ENGINEER BUILDING / 1
BUILDING AND SAFETY DMSION ADDRESS tj� p
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50 (�
MAIL /uQ
BATH TUB 1.50 ADDRESS !B
SHOWER 1.50 CITY ~ TEL.NO. A
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENS NO. p' CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GR UP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2.00 0� -3
WATER HEATER 1.50 V jrASTE OVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD O
OUTLETS OVER 30 0
5 PER SYSTEM
W
O„
FA
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Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER `
1 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.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 A THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DE RIB RESIDENT L PROPERT FINAL
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANIC
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
LACO 7 8 3 le% JAN 2 � � X 5 0 N
7
)BS-17 f0-B9 APPLICATION FOR PLUMBING PERMI T
BS-1 t
DIVISION OF BUILDING AND SAFETY Aj
Deportment of County Engineer
County of LOS"Angeles BUILCING
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUPT OF BUILDING
Mi LOCALITY
R LICANT O FILL IN NEAREST
CROSS ST.
OWNER DISTRICT NO. GROUP ZONES READY FOR INSPECTION
AMAILOF
DDRE 124
IT TEL.NO.
INDUSTRIAL I
CWASTE APPROVAL
PLUMB R INSPECTION RECORD
ADDRESS
CITY .�G TEL.N
LICENSE
aAWNUMBER TYPE OF FIXTURE OR ITEM FER
WATER CLOSET (TOILET) @ $1.00 $ �'
BATH TUB @ $1.00 -
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00 L ...
KITCHEN SINK @ $1:00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @, $1.00
CLOTHES WASHER @ $1.00
t
WATER HEATER @ .$1.00
GAS SYSTEM 414604 @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK ,e
PERMIT $ 1 00 ROUGH PLUMBING n
GAS PIPING
TOTAL FEE GAS VENT r ,,
I HEREBY'ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION •}}i 1�
AND STATE THAT THE ABOVE 15 'CORRECT AND AGREE TO COMPLY HOT WATER HEATER S i'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1 HEREBY CERTIFY THAT I APA PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED B LOS ANGELES COUNTY AND STATE OF /
CALIFORNIA OR THAT I M THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIA PRO ERTY.
SIGNATURE
OF PERMITTEE FINAL
OHN A.LAMBIE,COUNTY ENGINEER VALIDATION._ ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
OE. M.0'. CAS