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APPLICATION* FOR PLUMBI G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING D �. L" �'/�b
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY G1-r-
FOR APPLICANT TO FILL IN(PRINT OR TYPE) INEAREST
ST. `' 0p
NUMBER FIXTURE OR ITEM EACH FEE 2
WATER CLOSET 1.50 OWNER /4J Ai &A/
IL oe
BATHTUB 1.50 ADDRESS D 33 Ab koS '`/Li&Ao {'1'l�
I/
SHOWER 1.50 CITY p j„pCCY& TEL. NO.
LAVATORY 1.50 CONTRACTOR SHZJ h x,fE�J 1 O
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY j•TEL.NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. /3;3 I3 C ASS
SWIMMING POOL RECEPTOR 1.50 DIST
RICT GROUP O
LAWN SPRINKLER SYSTEM 2.00
W
ATER S BY
O
HEATER 1.50 INDUSTRIAL v
WASTE APPROVAL Z
O
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETS OV)ZR
5 PER SYSTEM .30
rn
Z
r
Plan clleck fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 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 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 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQ&ITHE
ANGELES COUNTY AND STATE OF
CALIFORNIA OR TEGAL OWNOF.AND INTEND TO
RESIDE IN.THE ABRESIDENTI RO E FINALSIGNATUREJACK R, ALLEN, SUPE VI INC MECHANI ALEG'R.
OFPERMITTEE ,
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
. o-2 0 .6 4% SEP 3 0 5 D 3.50
76A6&7-CE#817 10-67 F
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• • ' APPLICATION FOR PLUMBING. PERMIT
COUNTY OF LOS ANGELES
• ,. DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDI s 60$�3 0 S L m CH p kV b'
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUP'T. OF BUILDING LOCALITY
kiln pi,
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST
CROSS.ST.
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNER ff&^/ � r®Q
BATH TUB 1.50' ADDRESS 6 o 3 3 ASGArA-0
SHOWER 1.50 CITY• L •7l,,p CIT. TEL.
NO..f,Z5`- 93
LAVATORY 1.50 / C} CONTRACTOR VAS WAIAC?2 lam 13 „ efa
SINK1.50 ADDRESS 2 2
DISHWASHER 1.50 CITY �`iSl(; .TEL.NO. 9 iq
-1
CLOTHES WASHER 1:50 STATE LICENSE NO. Is 6 - •J 3 CLASS G
SWIMMING POOL RECEPTOR 1.50 DISTRICT 6. GROUP ZONE PROCESSED BY
>-
LAWN 3PRINKLER SYSTEM 2.00
C.2
WASTE
WATER HEATER 1.50 MUSTRIAL APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD V
OUTLETS OVER Ea
5 PER SYSTEM .30 r • y
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE O U
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. -
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I THE LEGAL OWN.%OF,AND INTEND TO If
RESIDE IN,'THE ABOVE D RI SIDENTI L' ROP FINAL
SIGNATURE
OF PERMITTEE UNM
JACK R. ALLEN, SPERISIG EC,H ANICAL
PERMIT VALIDATION CK. M.O. CASH --
PLAN CHECK VALIDATION CK. M.O. CASH