HomeMy Public PortalAbout5013 WILLMONTE AVE_Plumbing__ 76A68�-CP.SI7&59 .
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A..LAMBIS.County gamer ADDRESS ® 13 A)r epiZE
CASSATT D. GRIFFIN.Sup t of Bnildiag LOCALITY ZE Q
FOR APPLICANT TO FILL IN CRN OSS ST.
NUMBER FIXTURE OR ITEM OWNER r.1,016-e.4
.1` '6 -e�9
WATER CLOSET �(
RATH TUB ADDRESS +�L®
CITY C4$yll,�Y TEL.NO.
SHOWER
LAVATORY CONTRACTOR
i Sm ADDRESS
Q
DISHWASHER CITY TEL NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB- REGISTRATION NO. COUNTY ❑
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CLOTHES WASHER DISTRICT O. 1. Gam— ZONE 1 P BY
® WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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10 ORF $ I
APPROVALS DATF,
`— INSP TOR-S SIGNATURE
PERMIT $ 2 00 UNDER WORK C9 3. 0
TOTAL FEE ROUGH PLUMBING b
GAS PIPING C 6t
I HEREBY ACKNOWLEDGE THAT I 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 q�I7 18.
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT IEE
L OWNER OF THE ABOVE GAS TEST
DESCRIBED R`ESIDEMTIAL R UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITPE
- F[NAL
BF VALIDATION ROBERT A.WOOD. =_
M.0. GASB SUPERVISING MECHANICAL•ENWR
( O211IMAY 20 5 A 13.00
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76A667(CE-817)- 8/73
APPLICA IONTF�O�'R ' LyUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING d
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
City.
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE • CROSS ST.
WATER CLOSET j,75 OWNER Ikemoto
MAIL: -
BATH TUB 1.75 ADDRESS same
SHOWER 1,75 CITY TEL. NO. 443-7477
LAVATORY 1,75 CONTRACTOR GENERAL INSTALLATION CO.
SINK 1.75 ADDRESS 6558 WEST BLVD.
DISHWASHER 1.75 CITY Los Angeles TEL. NO. PL 3-2541
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO. `+ 36 151839 CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP 0NEJ OCESSED BY
LAWN SPRINKLER SYSTEM 1.75
c'. -v
WATER HEATER 1.75a'7CJ INDUSTRIAL
WASTE APPROVAL }:
GAS SYSTEM OUTLETS 1.75C3
INSPECTION RECORD U
OUTLETS OVER
5 PER SYSTEM .30 Ready P.for Ins ection'Now c
WATER SOFTENER
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 5
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE 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
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CAL FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDE L)�OP FINAL - — f
SIGNATURE (/�/�Q G
OF PERMITTEE
PERMIT V LI ATION /\//cK �t.0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH l
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