HomeMy Public PortalAbout5012 WILLMONTE AVE_Plumbing__ GE 817(REV.6/78) �/'
VAPPLICATIO OR PLU BING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT ORTYPE) BUILDING Ira
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ADDRESS � V �f�,/
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST. -•
SHOWER OWNER /"/
LAVATORY ADDRESS ,�/
/J- �' 0A -1C
SINK CITY � �p1 �,. TEL.NO.Wj 41S-
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM STATE LIC.
WATER HEATER LICENSE NO. CLASS
/ GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORKtadF
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
99
HOT WATER HEATER
PLUMBING.FIXT.VRES 9
GAS TEST 4;-;Xl ub
.Plan check fee UTILITY CO..NOTIFIED r g
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE U FINAL
Plan check applicant PLAN CHECK VALIDATION Q,,
Name ,-& ®� ps .�Q j 1/ r NNA
es see,—���od tvd� a �9
Address
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE d �7 n
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 1' A
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 5
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF.AND IN D TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 2 O o 1 Q Q 0
PROPERTY.
SIGNATURE .O 0 0 1 O' Q U
OFPERMITTEE I n 1 /r, �,
D`�f NO;� 1 PRO SSED u
INDUSTRIAL
WASTE APPROVAL
r/
.. -Ian C.
7SA667-L'E8 7-8-58
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER _
BUILDING AND SAFETY DMSION BUILDING
ADDRESS
OHN A. LAMBIE. County es
TT D. GEM N.Supt of Bonding LOCALITY /fs`/��C�
FOR APPLICANT TO FILL INSCROSS .
NUMBER FIXTURE OR ITEM ,Al /
f WATER CLOSET (✓ OWNER r�� AOL Ah zU KJ
MAIL
T RATE TIM ADDRESS
SHOWER .,� CITY TEId NO.
LAVATOEY L CONTBACTOE �?
sm ADDRESS
DE3SWASIM CITY ax-o..I as TEL NO.
CONTRACTOR'S STATE
LAUNDRY TUBJ REGISTRATION NO. 4e COUNTY
/ CLOTHES WASHER DICT NO. I (!%IUP 7,LJrpNE P CESSED BY
I WATER HEATER -d/-+ ✓ J ��
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
A.�.
APPROVALS
®� @ 08 DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING Z- - C /-i- ----✓
DOTAL FEE 5;;7 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 140T WATER HEATER -?.'`b l�6-"F^'r---
W1TH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST t aZ L s B' �•�.
LICENSED AS REQUIRED BY LOS ANGELES COUNTY-.AND STATE OF
CALIFORNIA OR THAT AMNE LEGAL OWNERF THE ASOVE UTILITY CO.NOTIFIED
DESCRIBED REBID T apRO RTY.
SIGNATURE FINAL
OF PERMITTEE
ROBERT A.WOOD.
®v VALIDATION SUPERVISING MECHANICAL ENG'R
CK.
R.0. CASH
4 53EADCE21 5A 12.00M