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'YSASe7 27 8-80 ID APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY.
COUNTY OF LOS ANGELES P M U "DI N G 1
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN INC. DISTRICT,NO. GROUP I ZONE ��ERMI NO.
791-
PLUMBER TTOM BROS. CRECEIVVlED13Y _ READYFOR D1iAo7TE ISSUED
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1112 WESTMINSTER AVE. ���'' FIRST INSPECTION
ADDRESS UUU
ALHAWWA, CALIFORNIA BUILDING
CITY TEL. NO. ADDRESS
a2z&PgimgosE AVE.
COUNTY LOCALITY
LICENSE NO. 1 1 1`5 EXPIRES 6m30-52
NEAREST TEMPLE CITY SLVD o
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MEEKER LAND C00'.
MAIL 3612 E. LIVE OAK AVE.
I WATER CLOSET (TOILET) @ O.50 FSr,0 ADDRESS
1 BATH TUB @ 0.50 50 CITY ARCAD I A. 'CAL I F o TEL. NO.
1 SHOWER @ 0.50 5_ 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS
1 LAVATORY (WASH BASIN) @ 0.50APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
I
STATE LAWS REGULATING PLUMBING.KITCHEN SINK @ O.50 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COU TY (CENSE. OR I AM THE LEGAL OWNER
OFmIroEF16
N P PERTY DE RIBED ABOVE.
GAS SYSTEM-3—OUTLETS @ O.q.O
S WATER HEATER @ O. PE
SLOP SINK @ o. INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.501
DRINKING FOUNTAIN @ 0.50( 7-3) 14/ 61f''
URINAL @ 0.50 -•1
HOUSESEWER @ 0.50.1 Q
Z
MISCELLANEOUS (�
. Q.
O
1
1
APPROVALS
1 DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING y /�
GAS VENT
CESSPOOL @ I.oO CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT . t.,00 GAS TEST
UTILITY CO. NOTIFIED
TOTAL FEE I $ 55100/ FINAL
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78A867-CE#8.17 5/63
APPLICATION FOR PL NG PERMHT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Annss ^
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. COUNTY ENGINEER �^
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY /
FOR APPLICANT TO FILL IN NEAREST
OSS i,
NUMBER FIXTURE OR ITEM EACH FEE
/ '.OWNER
WATER CLOSET $1.25
BATH TUR 1.25 D`D� 7
SHOWER 1.25 CI TEL. NO.
LAVATORY 1.25 CONTRACTOR
SINS 1.25 ADDRESS l� v
DISHWASHER 1.25 C TEL. NO. � �
LAUNDRY TUB 1.25 CONTRACTOR'S (�y/7� COSTUY El
NO. C7&
G
CLOTHES WASHER 1.25DISTRICT NO. GROUP ZONE CESSED BY
WATER HEATER 1.50 (� Jf� un
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1.50 INDUSTRIAL o_
GAS SYSTEM OUTLETS WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .90 U
INSPECTION RECORD �
O
a
In
Z
' A
APPMLS DATE INSPECTOR'S SIGI A,VRE
PERMIT $ r 2 00 UNDER•Sm� *B-WORK t/rte ,1 Jnr
CROUGH PLUMBING 4j I
TOTAL FEE
GAS PIPING
1 D HEREBY ACKNOWLEDGE THAT 1 HAVE REATHIS APPLICATION . GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAwB gEGULATING 'HOT WATER HEATER
PLUMBING.
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 I AM THE LEG OWNER OF.AND INTEND TO
RESIDE IN,THE AB?VE DESCRI ED 549SENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL �V l
ALIDATION ROBERT A.WOOD
CK.fi5. M.O. CASH SUPERVISING MECHANICAL ENG'R
4•`0 1 c 5 1 6-a' APR 26 5 Da.75N
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