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78A867-CE#817 12-84
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION UCROSS
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS,SUPT DF BUILDING ,
FOR APPLICANT TO FILL IN
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25 MAIL
BATH TUB1.25 ADDRESS
SHOWER 1.25 CITY 1 TEL. Ne
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LAVATORY 1,25 CONTRACTOR
SINK 1.25
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ADDRESS ,
DISHWASHER 1.25 CITY TEL. NO."-,0 Zt f 3 j
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GR PZ NE PROCESSED BY
WATER HEATER 1.50 J�
GAS SYSTEM OUTLETS. 1.50 G INDUSTRIAL }�
WASTE APPROVAL O.
OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD v
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK _
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH18 A LIGATION GAS VENT
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 ANWOR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO •.�a"is.�
RESIDE IN.THE ABOVE DESCRIBED RESIDENTIAL PR ERiY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE /YI/� FINAL
ALIDATION ROBERT A.WOOD
CK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
_ . i Flj;o 2 1 5 'S MAY 19 5 D 4.7 5 N
76A667 APPLICATION FOR PLUMBING PERMITDBS•I7 3-55
DIVISION OF BUILDING AND SAFETY t4,7:._t..
Department of County Engineer li l li —
County of Los Angeles
WM.J. FOX. COUNTY ENGINEER BUILDING
ADDRESS _1-
CASSATT D. GRIFFIN, SUPT OF BUILDING
LOCALITY Temn1P Citv
FOR APPLICANT TO FILL IN NEAREST
CROSS S j
OWNER DISTRACT NO. GROUP ?ONE READY FOR INSPECTION
MAIL �J
_ADDRESS
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER Earl (Pat) Stmil?VQInc. INSPECTION RECORD
ADDRESS 2019 TV. H-yt P.n. 4n8 Q �.r..• U ti
CITY41559
F1 Mint P TEL.NO. GT ry`j
LICENSE NO. 149?�6
NUMBER I TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) S 7 ,nn
1 BATH TUB %nn `
SHOWER
7 LAVATORY (WASHBASIN) I 7 ^^r)
1. KITCHEN SINK IjC ^r 7 100
,�
DISHWASHER "("y ... -.
LAUNDRY TUB OR TRAY en- T_
CLOTHES WASHER
i
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TOTAL NO. Ccs 0.80 APPROVALS
GAS SYSTEM OUTLETS @ 1.00
^^^ DATE INSPECTOR'S SIGNATURE
� Vl.!
WATER HEATER na 1.00 UNDER SLAB WORK
PERMIT 7 00
ROUGH PLUMBING `�
� I
_ Kj
GAS PIPING
TOTAL FEE I ll oo GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SHOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES C UNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL NER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDE E PROPERTY, /'
SIGNATUROF PERM ITT E FINAL -
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION R. A.WOOD. CHIEF PLBG. INSPECTOR
C4j906r, OCT30 3 11 .00