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HomeMy Public PortalAbout9163 WEDGEWOOD ST_Plumbing__ + 76A667`(CE-817)- 5/78 AP CATI FOR P BINE: PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS !� HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST ST. G NUMBER FIXTURE OR ITEM @FEE CROSS WATER CLOSET 1,75 S^ OWNERMAIL a BATH TUB 1,75 9T, ADDRESS � SHOWER 1,75 ` 75 CITY , TEL. NO. LAVATORY 1,75 ("O CONTRACTOR SINK 1.75 7 ADDRESS DISHWASHER 1.75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE ` LIC LICENSE NO. CLASS . (d SWIMMING POOL RECEPTOR 1.7511 LAWN SPRINKLER SYSTEM 1,75 DC O. UP Z NE F `CES D BY WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v OUTLETS OVER 5 PER SYSTEM •30 O F U W N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE 5 APPROVALS DATE INSPECTOR'S SIGNATURE Plan feck applicant UNDER SLAB WORK f Jw Name ROUGH PLUMBING Addresx, GAS PIPING 7 -Ao-'1/ City I. NO. GAS VENTr•. �,`•�1 _ �+/ HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION I AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES • Y,,'SSj1,''f4! I/ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELE COUNTY AND STATE OF - CALIFORNIA OR THAT I AM THE LE L ER OF• AND INTEND TO RESIDE IN THE-ABOVE DE RIBE0 R D T AL PROPERTY. FINAL. SIGNATURE - 11 OF PERMITTEE PERMIT VALIDATION CK. .0. CASH PLAN CHECK VALID N CK. M.0 CASH 091� AY 2:1� 5 0 22.25A% 76A667A • .3 ��1 CE 817(REV.11/78) '•' �� ���444 APPLICATION R PLUMB P RM IT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING h� �! NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY - NEAREST BATH TUB CROSS ST. p�cJ SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY �_ TEL.NO. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS If- SWIMMING POOL RECEPTOR CITYell TEL..NO� 8�. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLAS GAS SYSTEM 'LeiTt'LETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING o.d GAS PIPING OGS GAS VENT at HOT WATER HEATER PLUMBING FIXTURES GAS TEST 2 vo Plan check fee UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL m .d .- Plan check applicant: PLAN CHECK VALIDATION Na Address O 296 1.3 A Ci T .No. i # 000005 I HEREBY ACKNOWLEDGE THAT I HAVE HIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2'o b 1 3,O 0 AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS o 0 0 1 a Q Q U REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL R OWNER OF,AN NTEND TO RE E IN THE ABOVE DESCRIBED RESIDENTIAL 0328-80 Z r� a O PROPE SIGNATURE J�G O , AIR OF-PERMIT DI TRICT NO� CE ED BY INDUSTRIAL WASTE APPROVAL -