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APPLICATION FOR PL MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION nnn�ss j JJ
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPIT OF BUILDING,. LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. .{. ..L-o
NUMBER FIXTURE OR ITEM EACH FEE
OWNER �
WATER CLOSET $1.25 MAIL
BATH TUB 1,25 ADDRESS
SHOWER 1.25 CITY TEL. NOS"7 t2-4c
LAVATORY 1.25 CONTRA
oll
SINK 1.25 Z ADDRESS •7 Sr '
DISHWASHER 1.25 CITY CTOR'S )V TEL. NO j-3
STATE
LAUNDRY TUB 1.25 REGISTRATION ON NO. ✓ ✓ COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P ESSED BY
WATER HEATER 1.50
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL r1'
WASTE APPROVAL O.
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD O
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APPROVALS DATE INS ECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK ,� 1
ROUGH PLUMBING `
TOTAL FEE GAS PIPING I ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT I
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES a1I?•1
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 A VE DESCRIBED RESIDEN AL PROP RTY UTILITY CO.NOTIFIED
SIGNATURE V I��2
OF PERMITT FINAL
OALI�ATION ROBERT A.WOODO. CASH SUPERVISING MECHANICAL ENG'R
LXo 6684 OCT21 5 D 4.50-- 0
76AS67 17 a=so la - APPLICATION FOR PERMIT 1.
- DEPARTMENT OF BUILDING AND SAFETY 'PLUMBING 1
-
COUNTY OF LOS. ANGELES
WILLIAM J. FOX,. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRI5'NO. GROUPZONE PERMIT NO.
1) �L I _� 88/2 Z
PLUM19ERVALLFY RQUIEVARD 2111MRINO RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION 9 ® �o
I.ADDRESS900 EAST VALLEY BLIQate!( ® a b g/
BUILDING /J B
CITYROSEMEAD TEL. NO.AT 9.9710 ADDRESSCOUNTY L7 Q
L CENSE NO. 93M EXPIRES6-30,67 LOCALITY l (f
NEAREST
PERMIT FEES CROSS ST:_ . ...e. Iz
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER vp1 f f"'� yL•Gt.� �
MAIL
4 WATER CLOSET (TOILET) @ O.SO. S ADDRESS �{, !!/A�.-!" � /�p 1611 1
BATHTUB @ 0.50 J741. CITY ~ rYLEL. NO.A �15
SHOWER @ 0.50 1 HEREBY AC C/NOWLFDGE THAT 1 HAVE READ THiB
�- LAVATORY (WASH BASIN.) @ O.SO APPLICATION AN Q STATE THAT THE ABOVE IS.CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY .ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ 0.50 0 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ O.SO .C, () ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOV
GAS SYSTEM L OUTLETS @ 0.50 '(J
SIGNATURE OF -jj���J��
WATER HEATER @ O.SO. Aj^Q., ., _ PERMITTE �O l w" r
SLOP SINK @ o.so INSPECTION RECORD.
FLOOR.SINK @ 0.50
FLOOR DRAIN @. 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 J
HOUSE'SEWER @ 0.50 Q
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MISCELLANEOUS (�
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APPROVALS
'o-OV 1/f ul f _ DATE_ INSPEC_TOR'S NAME
ROUGH PLUMBING O
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 : SEWER .
PERMIT 1.00 GAS TEST f
UTILITY CO. NOTIFIED o
TOTAL FEE SAO FINAL