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APPLICATION FOR :PLUMBING PERMIT 1 .
COUNTY OF LOS ANGELES AC474
DEPARTMENT OF COUNTY ENGINEER
BUII.DING AND SAFETY DIVISION BUILD=
Tromf A. LAMM, Countyes ADDRESS Gt!/ L L- A-/O Al E
CASSATT D.GaOTM.SW t-=mg > LOCALITY rJ5 m PL. C /
FOR APPLICANT TO FILL IN NEAREST
CROSS ST:
NUMBER FIXTURE OR ITEM
OWNER D d A✓'
WATER CLOSET G
MAIL .
RATE TUB ADDRESS E /� EL l i✓
SHOWER L CITY OSE R TEL.NO.
�✓ LAVATORY CONTRACTOR valley PlumbingCo.
amts. „ ADDRESS 442 We Fleetwood Pl.
DISSwASIM CITY Glendora TEL.No. Ed 5;12
LAUNDRY TCB CONTRACTOR'S c,6®®47 STATE p
REGISTRATION NO. COUNTY
CLOTHES WASHER ?/ Dl!r NO. GP ZONE PR CESSEp BY
WATER HEATER
1!4GAS-SYSTEM INDUSTRIAL
WASTE APPROVAL.=
INSPECTION RECORD
JA
cb
• APPROVALS
� ROg.
g�IT rrEM 6 gE $ DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING --14%(o is
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING v
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR �,ASTEST
LICENSED AS REQUIRED BY LOS A ELES COUNTY AND STATE OF
CALIFORNIA OR THAT I M THE EGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED '7�� N�
DESCRIBED RESIDENTIA ROPER
SIGNATURE !,4'
OF PERMIT" FINAL
ROBERT A.WOOD.
®p ALIDATION SUPERVISING MECHANICAL ENG'R
O. CASH
��0882 -9 c2F, 5. A 12.00 n
76A667 (CE-817)- S/73 �FPLUMAGPERMIT
C�
APPLICATIO
COUNTY OF LOS ANGELES
DEPARTMENT-OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: FBINGESS /GL/;1.6AJ LHARVEY T. BRANDT, COUNTY ENGINEERLIT� -CFOR APPLICANT TO FILL IN (PRINT OR TYPE) S S 6z'.)0V_ ZGL
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1.75 OWNER Z �
MAIL_
BATH TUB 1.75 ADDRESSw'?/3
SHOWER 1.75 CITY 61r' TEL. NO.
LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS '
DISHWASHER 1.75 CITY ( TEL. N0.
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.75
DIST T NO. GROUP ZONE 1,.,,---PROCESSEDLAWN SPRINKLER SYSTEM 1.75 '
WATER HEATER 1.75INDUSTRIAL `
WASTE APPROVAL / Or
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER
5 PER SYSTEM .30 C
CD
• a
y
Plah check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 9 00
TOTAL FEE rp
APPROVALS DATE- INSPECTOR'S SIGNATURE
Plan the applicant �. UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORESIDER INA OR THAT TH:ABOVE I SgR;THE REG IDENT ALRP OPER TY�AND ND TO
@ FINAL
SIGNATURE &
OF PERMITT� N�
PERMIT VA ID ION CK. M.0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
1 .3 9""'OE `/ 0 6.5 0 AW