HomeMy Public PortalAbout8604 ROCCUS LN_Plumbing__ f76A664C,(CE-}17H)�-9 75
APPLICATION FOR PLUMBING PERMIT {�
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) ADIDRESS 6
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY S' aA,39,ji�-L .
NEAREST
BATH TUB CROSS ST. J8 44
SHOWER OWNER t9 &/�����
LAVATORYMAIL
6P-0 ADDRESS rj /Ll 7
SINK CITY 7 r! TEL. NO.�g 2OOS7
DISHWASHER I CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR //
LAWN SPRINKLER SYSTEM STATECITY C_6 U �i?/��lLIC
T TEL. NO. 6,f �f
WATER HEATER Q� LICENSE NO. 31.n1/ CLASS. J
GAS SYSTEM OUTLETS I DISTRICT NO. I GROUP jj�NEJ OCES9 BY
VTLETS OVER
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL yv�
INSPECTION RECORD y
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE IA7
Plan check applicant
Name �� L � �� APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address 5 j 0—9 5 r
ROUGH PLUMBING
City Gov Tel. No. lvdgVA GAS PIPING T~
1 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 HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I 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 LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCESIDENTIAL P50PERTY. UTILITY CO. NOTIFIED
SIGNATU RE
OF PERMITTEE4 FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT V IDATION CK. M.O. CASH
1s6-*V A 27.00Aub
� N,A88�Y dE#8170 5169
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
.DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A.LAMBIE.'COUNTY ENGINEER �)
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER 11 _
WATER CLOSET $1.25 MAIL
/ BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
10 LAVATORY 1.25 a D 'CONTRACTOR. ,qL
SINS 1:25 ADDRESS s�
DISHWASHER 1.25 CITY . NO. 3
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑.
REGISTRATION NO. Z COUNTY ❑
CLOTHES WASHER 1.25 .J DISTRICT NO: GROUP ZONE PROCESSED BY
WATER HEATER 1.50 "� j - �
}
a
GAS SYSTEM OUTLETS 1'm INDUSTRIAL
WASTE O
OUTLETS OVER 5 PER SYSTEM .80 U
INSPECTION RECORD
or
a
. Z
APPROVALS DATE INSP4CTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING f P.
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1. HAVE READ THIS APPLICATION GAS VENT
AND STATE TXAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS I{EGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIR BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA
OR
THA 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABO"E ESCRIBED RESIDENTIA OPERTY. .UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE 2 "
FJNAL �
r
DATION ROBERT A.WOOD
CK. M..O. ". CASH SUPERVISING MECHANICAL ENG'R
LAAO 3 0 1G AUG 2 45 A 16.25-