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APP'LICATI'ON FOR PLUMBING PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING AQ 4 V�
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SIJP'T. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIYTURE OR ITEM EACH FEE
OWNER �S
WATER CLOSET 11.25 HAM
BATH TUB 1.25 ADDRESS
CITYNO
SHOWER 1.25
LAVATORY 1.25 1 -6'0
CONTRALTO
SINS ADDRESS zV
"
DISHWASHER 1.25 CITY TEL. NO.
LAUNDRY TUB 1.25 STATELI
LICENSE O. CLASS
CLOTHES WASHER 1.25 DISTRICT N GROUP ZONE PROCESSED BY
WATER HEATER 1.50 o
R_ +
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL0101-
O
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 b CTION CORD V
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APPROVALS• DATE SPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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
.PLUMBING. .HOT WATER HEATER
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 t A THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE D CR ED RESIDENTIAL PROPS RT UTILITY CO.NOTIFIED
SIGNATURE
OF PERM ITT
FINAL
VAIM'ATIO
CK. M.O. CASH
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LG 4. 8 .6 6"'Do MAY 2 8 5 'D 3.50- 4
%D.B. a'MGM SETS 12-43 - APPLICATION FOR
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING '
Wm.J. FOX.CHIEF ENGINEER
NATURE OF INSTALLATION DINMICT NO. GROUP ZONE . P; RM C O.
ROUGH FIXTURES COMPLETE � � _ d eSJ Q
HEATER CESSPOOL -I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
�• FIRST INSPECTION
AS M18CELLANEOU (✓"` ",main
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APPLICANT pF�ILL IN HEAVILY OUTLINED PORTION ONLY
013
NAME sfasCLP.d// +�! �L/ff:4�9�sy � ADDRESS /���'%�I �� !�.�-/•lJE9^
ADDRESS Olzio '�, y /rte LOCALITY / / �J
NEAREST
CITY •,�� TEL.No.. ®•`)i
COUNTY
CERT.No. EXPIRES -Y�-�5� 01 NAME
LOCATION OF SEPTIC TANS, OR CESSPOOL. z MAIL
NORTH O ADDRESS
CITY TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES OUNTY CERTIFICATE OF QUALIFICAYON.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS . �
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,
SOUTH J
(DESCRIPTION OF WORK _z {
HATH TUB FURNACE i
HOW ER DISHWASHER O y'
ILAVATORY REFRIGERATOR
TICITCHEN SINK WATER SOFTENER
-MOOR SINK SAND TRAP
SLOP SINK - FLOOR DRAIN
WASH TRAY URINAL APPROVALS
_WATER CLOSET DRINKING FOUNTAIN DATE ��1Nf9PaeTOR•e NAME
WATER HEATER DENTALLAVATORY ROUGH PLUMBING _1 I' l� r/r ,�,,(
ETER_ LOun ODA FOUNTAIN GASPIPINl9
r
-GAS VENT /..
CESSPOOL /
TOTAL NUMBER"OF FIXTURES 3 045 SEPTIC TANK I
CESSPOOI SEPTIC TANK SEWER I .
$ UTILITY CO.NOTIFIED
TOTAL FEE <,CA 3 O O 3 0 0
FINAL
76A667(CE-817)- 5/73 (—) 1'7q
APPLICATION FOR PLUMBING, PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION suILDINc `
MAKE CHECKS PAYABLE TO: ADDRESS' uJ(Sd'6')L- to()oct-
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
%gym PIC i
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST ✓
�
NUMBER FIXTURE OR ITEM @ FEE CROSS ST. �6A0
WATER CLOSET 1,75 OWNER 0 �7
MAI L.,
BATH TUB 1.75 ADDRESS rs
SHOWER 1,75 CITY TEL. NO., )
LAVATORY 1,75 CONTRACTOR
SINK 1.75 ApDRESS (0 C1av 6, �14�Gt-
0ISHWASHER 1.75 CITY e ., TEL. NO. A ?Q ?o
CLOTHES WASHER 1.75 STATE G O LIC
LICENSE NO. Q 6 CLASS
SWIMMING POOL RECEPTOR 1,75
DISTRICT NO. GROUP NE- OCESSED BY
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1.75 IN
WASTE APPROVAL �.
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER ,30
5 PER SYSTEM
CD
Lu
W
d
N
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT 1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
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 ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE OESCRI&ED RESIDE T L PROPERTY.
FINAL
SIGNATURE
OF PERMITTEE JJ��ee
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
REA" Y F 0 9 s -mnR .7 . 5 0 4.7 5 & 0
� �r � I�� PEC..'
.:76We67 17 5-30 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES '
WILLIAM J. FOX. CHIEF ENGINEER
.,)FOR APPLICANT TO FILL IN DISTR�T NO. GROUP ZONE PERMIT No
ro
PLUMBER lr'`fi (>[��j�✓ir ,
/ t���Ljjj ..- f r REC IV BY REA FO DAT ISSUED
✓ �/ [511✓ F R�STPT
ADDRESS J
�+ HUILDIN6
CITY /.+✓Sl',�.�, !✓��' '✓ TEL. N (XJ �.�JJ ADDRESSJ� r
COUNTY ` ,tom A,, (1 •�+'f LOCALITY t�3 d !!-'t(_. ✓,'F�s'�� ��,
LICENS NO. /. !11' EXPIRES W `J NEAREST A f
PERMIT FEES CROSS ST. W.i / /.,7( %r wt i`di Vit✓�:
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER/d•//�*.. .. .% i b'sw'P�•'%G •"(.%v:�.J�,C'�/�C..•J
MAIL f -t
WATER CLOSET (TOILET) @ 0.5.0 S ADDRESS ~/� L�'.S 4 P,` f t:: 3. t ••c+ �% ��
BATH TUB @ 0.50 CITY. , i�✓ 1 y/ Ai'- TEL!NO.
SHOWER 0 0.50 1 HEREBY ACKNOWUEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATIG"N AND SyATEj•THAT THE ABOVE IS CORRECT AND
AGREE"1O COMPLY WVH ALL.COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50. STATE LAWS REGUL%TfNG PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LI ENSE. OR. I AM THE LEGAL OWNER
OF THE RESIDENTI 'PROPERTY DESCRIBEDA OVE.
GAS SYSTEM OUTLETS @ 0.50 /
p SIGNATURE OF /// A j7 pt�� �
p WATER HEATER 0..50 PER MITTE
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.5o ..
DISHWASHER @ 0.50
DRINKING FOUNTAIN ® 0.50
URINAL @ 0.50 „J
HOUSE SEWER @ 0.50 a
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MISCELLANEOUS (�
a
_ o
APPROVALS
'DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS. PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @. 1.00 SEWER
PERMIT . 1.00 GAS TEST
TOTAL FEE
UTILITY CO. NOTIFIED
S
FINAL �pOert
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