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76 A 667 — CE 817 7-69 Q�
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APPLICATION FOR PLUMBING PERMIT
-COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER /
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS l�J
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM EACH FEE' CROSS ST.
/ S
WATER CLOSET 1.50 OWNER
MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY TEL. NO.
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESSe—
DISHWASHER 1.50 CITY r+ / TEL. NO Y'Y-d:gZg
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. p�3��O CLASS (2
SWIMMING POOL RECEPTOR 1.50
DISTRICT NQ. GROUP N FtOCE 'E Y
LAWN SPRINKLER SYSTEM 2.005
7
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD u
OUTLETS OVER 30
5 PER SYSTEM Z.O
IIJ
Oe
N
Z.
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE $ 00
TOTAL FEE APPROVALS DATE PECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
D /
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST _ �L
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED '
LTCBEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CIFORNIA OR THAT I AM THE LEGAL OWNER OF. ND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIALRTr. FINAL
SIGNATURE JACK R. ALLEN, SUPERVISIN ANICAL ENG'R.
OF PERMITTEE 7�'p
PERMIT VALIDATION K. M.O. CASH
PLAN CHECK VALID ON CK. M.O. CASH
tL 60 ^ 6 tlti6 2 5 D $•,� 5N c
71(3-((7
0113-17 3.99 APPLICATION FORPLUMBING PERMIT' 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County Of Los Angeles BUILDING n
WM.J.FOX, COUNTY ENGINEER ADDRESS (Q 0 zi ¢y
CASSATT D.GRIFFIN.SUPT OF BUILDING q�
mm LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER DISTRICT/�'lO�� GROUP I ZONE READY FOR INSPECT ION
MAIL
ADDRESS (p J' l/V O GI !� , d ��!/•Iy_
INDUSTRIAL
CITY—TC H IPLA— ELpNO. WASTE APPROVAL
PLUMBER j:Vj-
& tia INSPECTION RECORD
,+
ADDRESS 4:
CITY TEL.NO. !!Y I= Or� R�3 �`l� rr A K& �
LICENSE N . "6,4 3.-S, ( ;ro -9"?;,1, "M
NUMBER TYPE OF FIXTURE OR ITEM FEE '
WATER CLOSET.(TOILET)
BATHTUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO. @ 0.80 APPROVALS
GAS SYSTEM OUTLETS ® 1.00 DATE INSPECTOR'S SIGNATURE
WATER HEATER_ @ 1.00 UNDER SLAB WORK p�
PERMIT S 1 00 ROUGH PLUMBING p ,/6 �k
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP (CATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBINGPLUMBING FIXTURES
.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO.NOTIFIED
CALIFORNIA OR T I AM THE LE L OWNER OF THE ABOVE
DESCRIBED RE EN AL PROPERTY. t
SIGNATURE //66,nn
OFPERMITT � ` r FINAL �30� .� AJ r(!f l/
WILLIAM J.FO OUNTY ENGIN VALIDATION R.A.WOOD.CHIEF FLBG. INSPECTOR
._A-06 5 2 8-Ln AUG 11 3 1 .8 0 in
MA667-CSe17-9-58 .
APPLICATION FOR PLUMBING PERMIT 1 =
COUNTY OF LOS ANGELES
DEPARTIVIENNT OF COUNTY ENGINEER
BUILDING. AND SAFETY DIVISION SUlLDIIIG
JOHN A. LAMBIE. County Reei ADDRESS'
CASSATT D.GWFIN.Sup't of �ild9ng LOCAL
IM
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
WATER CLOSET owmmKam
BATS TUB ADDRESS ,
SHOWER CTPY TEL.NO
LAVATORY CONTRACTOR
SINK ADDRESS 2- 7
//
DISHWASHER - CITY lQ�
CONTRA TORS" STATE
LAUNDBY TUB REGISTRATION NO. ci t f CODNTY ❑
CLOTHES WASHES 'DISTRICTN GROUP ZONE P SPY
r
WATER HEATER
GAS'SYSYE�4 INDUSTRIAL
WASTE APPROVAL
ngSPECTION RECORD
wp F / 61L 1 �l
i✓ !fie
A=
APPROV
t @ Rica PER
8°�R r=
� l
DATE INSPECTOR'S SIGNATURE.
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING
1-1 TOTAL FEE GAS PIPING
I HEREBY ACKgIOWLEDGE THAT 1 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
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS .REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AN THE LEGAL 0 N OF T 'rABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE'
OFPERMITTE _�_ FINAL- �' ��/ r�✓v;;
ROBERT A:WOOD.
®p ALIDATION SUPERVISING MECHANICAL ENG-R
CK.
X.0. CASH
tpo 4 .3 8--3 APR 1 5 A 3.0 0 '`
OB9179.BB APPLICATION FOR 'PLUMBING PERMIT
DIVISION OF BUILDING AND SAFETY
Department of County Engineer `
County of 1oB Angeles BUILDING ®J N�6.
WM.J.FOX, COUNTY ENGINEER ! P
ADDRESS21
CASSATT D.GRIFFIN.SUPT OF BUILDING .,
LOCALITY !/
FOR APPLICANT TO FILL IN NEAREST-
. CROSS ST.
OWNER DISTRICT NO. GROUP ZONE READY FOR INSPECTION
MAIL p� f
ADDRESS �7 Z
CITY Tg cr TEL.NO. INDUSTRIALWASTE APPROVAL
PLUMBERr . INSPECTION RECORD
ADDRESS yf.L 1® (l 4vl�jiJpy�JQ
_CITY A �L i=6 TEL'NO, //
LICENSE NO.
AU M 0
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) S
BATH TUB
SHOWER
LAVATORY (WASH BASIN) .
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
C THES WASHER
_1101 P
TOTAL NW 0.80
APPROVALS.
DATE INSPECTOR'S SIGNATURE
GAS SYSTEM OUTLETS ' @ 1.00
WATER HEATER- @ 1.00 UNDER SLAB WORK
ROUGH PLUMBING
P.ERMI7' $ 1 00
/I GAS PIPING,
TOTAL FEE GAS VENT
I,HEREBY ACKNOWLEDGE THAT 1 HAVE READ,THIS APPLICATION HOT WATER HEATER
ANP 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. COUNTY AND STATE OF UTILITY CO.NOTIFIED
CALIFORNIA OR.THAT�_] AM THE LEGAL OWNE OF THE ABOVE
DESCRIBED RESIDENTI IIU PROPERTY.
SIGNATURE ) ti
OFPERMITTEE 'U FINAL 0
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION R.A.WOOD.CHIEF PLBG.INSPECTOR
ICO S 9 0 21 , OCT 1.3• 3-
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