HomeMy Public PortalAbout5209 SANTA ANITA AVE_Plumbing__ 76AG67 (C6-817) - 1/75
APPLICATION .FOR PLUMBING PERMIT
COUNTY OF..LOS ANGELES
DEPARTMENT-OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS3,-�
HARVEY T. BRANDT, COUNTY ENGINEER -,
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST y
CROSS ST.' .h.eR�1�
NUMBER FIXTURE OR ITEM @ FEE OWNER Pfd c
WATER CLOSET 2.00
MAIL
BATH TUB 2.00 ADDRESS
SHOWER 2.00 CITY ' // TEL. NO.
LAVATORY 2.00 CONTRACTOR
SINK 2.00 ADDRESS /
DISHWASHER2.00 CITYTEL. NO. ,f7,2
CLOTHES WASHER 2.00 STATE LIC
LICENSE NO. CLASS C r -
SWIMMING POOL.RECEPTOR 2.00
DISTRICT NO.GROUP ZONE R�Ai SSE B
LAWN SPRINKLER SYSTEM 2.00 L ,
WATER HEATER 2.00 00 INDUSTpIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM •SO U
• O
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W
CL
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE O
APPROVALS DATE I.NB PECTOR'8 SIGNATURE
Plan check applicant ,Jr� UNDER SLAB WORK
Name ROUGH PLUMBING J`
A
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND. STATE THAT THE ABOVE 'IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES •^
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING f
PLUMBING. GAS TEST
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED v
LICENSED• AS REOUIRED BY LOS ANGELES COUNTY AN -TATE �•
CALIFORNIA OR THAT I AM THE LEGAL OWNE F, fu TI: 0
RESIDE IN THE ABOVE DESCRIBED RESI TY. FINAL
51GNA.0 RI-
OF PERMIT E -
PERMIT VALIDA ' N cK. M.O: CASH
PLAN-CHECK VALIDATION CK. M.O. CASH
2t .0 :t� S 7.50e�
le PLUMBING 1
DEPARTMENT OF COUNTY ENGINEER
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS //77��
FOR APPLICANT TO FILL N LOCALITY C�
BUILDINGe�j9 w NEAREST p
7 • CROSS ST.
ADDRESS C� � .. � .y= '✓/�
DISTRICT NO. GROUP 'T®E P RMIT NO.
LOCALITYrvL�'. P . � � � ��• �-s �� ®� / �oGJ
CROSS ST. ` �� /V ` RECEIVED BY Ready for Inspection DATE ISSUED
OWNER �C / I 1 � •/ �'�nL ��6� ���
MAILr INDUSTRIAL ►
ADDRESS J �r'� WASTE APPROVAL
CITY ,vp
_ 7 INSPECTION RECORD
� rsTlEL.N0. �f
PLUMBER6/ ( P !�c`, �)I �"!/ /
ADDRESS /G�L7, *JW &le f7 17 rp
CITY A ' -/�� -��. TEL.NO. Cf� /
/f+ Alt)� ❑STATE
LICENSE N0. '�J .. .FCUUNTIJ
PERMIT TEES Q
_z
NUMBER TYPE OF FIXTURE OR ITEM FEE to
WATER CLOSET(TOILET) 0.80 $ 1 C
O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80 2IC
KITCHEN SINK AS H AL @ 0.80 fS�
LAUNDRY TUB OR TRAY @ 0.80
SLOPSINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.60
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
t� GAS SYSTEM......_....._OUTLETS @ 1.00 0
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
�P .aP•_%�n,- :1 +_� P
DATE
/INSPECTOR'S SIGNATURE
UNDER SLAB WORK �• �S7. A/P !jig
�'I /✓T
PERMIT ; I 00 ROUGH PLUMBING JJI,��_;ry �1t,7.r�;• e.
TOTAL FEE S GAS PIPING j,"-/J
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES �q.
AND/
OR LICENSED IFY THAT I AS REQUIRED BYPLOS ANGELROPERLY ES (STERED
COUNTY GAS TEST YVL��vL.�r
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE D CR BEDff RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATUREL� +�•`RMITTFOPE ) _ FINAL
C; fa v�e..as.•- �
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