HomeMy Public PortalAbout10912 WILDFLOWER RD_Plumbing__ 76ASB-1
CE X17 B-159 APPLICATION FOR PLUMBING PERMIT 1
BUILDING AND SAFETY DIVISION
Department of County Engineer f�
County of Lob Angeles ADDRESS
JOHN A.LAMBIE,COUNTY ENGINEER DD
CASSATT D.GRIFFIN,SUPT OF BUILDING /.'
LOCALITY
FOR APPLICANT TO FILL IN ' NEAREST
CROSS ST.
OWNER t® . tr/Q DISTRICT NO. GROUP I ZONE I READY FOR INSPECTION
MAIL s3/
ADDRESS
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER / INSPECTION RECORD
ADDRESS 7 T
CITY Allkmo Q-0/P TEL.NO. �`/ rI j
4111 7—
LICENSE NO. / go® 7'F7 1 v
NUMBER TYPE OF FIXTURE OR ITEM FEE _ ' /J
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASHBASIN) @ $1.00 /
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 7 00 ROUGH PLUMBING
F"-
GAS PIPING I W f2✓ t
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER i F Ar (/L
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES iyrnkvr�
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED �•�' .v,`4t•t'
DESCRIBED RESIDENTIAL PROPERTY. '
SIGNATURE ` ,9
OF PERMITTEE FINAL is t�Wf'
ROBERT A.WOOD,
JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION .SUPERVISING MECHANICAL ENG'R
CK. M.o. sR
3 9 7 3In �lA�1 1 3 8.00 .9
76 A 667—CE 817 8/68
APPLICATION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY'DMSION fB1ILDING
JOHN A. LAMBIE. COUNTY ENGINEER DDRESS L,
COLEMAN W. JENKINS. SUP'7. OF BUILDING OCALITY C 1D
FOR APPLICANT TO FILL IN(PR NT OR TYPE) OARESSS TT• E
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNER
ADDRESS
HATH TUB 1.50 �.
SHOWER 1.50 CITY CON TEL. NO.S'1 : aL
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS'
DISHWASHER 1.50 CITY TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GRID Z PRO 8F�BY
LAWN SPRINKLER SYSTEM 2.00Vy
O
WATER HEATER 1.50 INDUSTRIAL v
/ f WASTE APPROVAL o
GAS SYSTEM OUTLETS 1.50 INSPECTION CORD 2
OUTLETS OVER 30 �+ y
5 PER SYSTEM
Z
I —
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE d
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
LRESIMIDE
Tel. NO. HOT WATER HEATER
EREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST (�
BING.
EREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
SED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
ORNIAORTHAT1 AM THE LEGAL OWNER OF,AND INTEND TO
IN.THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINALATUREX JACK R. ALLEN, SUPERVISI HANICAL ENG'R.
PERMI7TTEE
PERMIT•VALIDATIO C K. M.O. CASH.
PLAN CHECK VALIDATION CK. M.0. CASH
LAP- s 8 3 9 FEB2.3 5 Q 3.50-
.