HomeMy Public PortalAbout9151 WOOLLEY ST_Plumbing__ 74!A667A(QE 8 1713-11/76 -
APPLICATION FOR PLUMBING PERMIT
BUILDIN. /RIL/VD SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGST
NUMBER. FIXTURE OR ITEM ® FEE ADDRESS li
' WATER CLOSET LOCALITY �•
BATHTUB NEAREST b
CROSS ST. v%A
SHOWER OWNER
LAVATORY MAIL
ADDRESS �
SINK �e
CITY � TEL.NO �
DISHWASHER CONTRACTOR
CLOTHES,WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL:NO.
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS DISTRICT NO. GROUP NE CESSED Y
OUTLETS OVER
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL 0
INSPECTION RECORD
Id
ul
Plan check fee
PLUMBING PERMIT ISSUING FEE$ 1Y 5D
TOTAL FEE
Plan check applican
Name / APPROVALS DATE I.NSPECTOU'S SIGNATURE
UNDER SLAB.WORK
Address ROUGH PLUMBING
City Te.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION'AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATt OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITFINAL
PLAN CHECK VALIDWN CK. M.D. CASH PERMIT VALIDATION M.O. cases
1 1 3LAUfG 10 5 0 1 305 0 Amo
APPLICATION R PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING `
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY'
GV
FOR APPLICANT TO FILL IN (PRINT TYPEI CREAREST
OSS ST. a 1,'3
NUMBER FIXTURE OR ITEM FEE
2. 0 OWNER
WATER CLOSET
`
MAIL 1 q
BATH TUB 2. 0 ADDRESS l
SHOWER 210 CITY C• TEL. O
LAVATORY 200 CONTRACTOR
SINK .00 ADDRESS
DISHWASHER .00 CITY
CLOTHES WASHER .00 STATE • LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR .00
DISTRICT NO.GROUP ONE PFVPCESSED BY
LAWN SPRINKLER SYSTEM 2 pp 08
J.�' � 6-
WATER HEATER 2, 0 INDUST IAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.JO INSPECTION-RECORD
OUTLETS OVER
.5 PER SYSTEM .30' v
CL'
o
C�7
W
. O-
N
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE .S 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING ...> /10
Address GAS,PIPING,
City Tel. No. GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ -THIS APPLICATION HOT WATER HEATER
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 I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED As REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALI RO RNI.A OR THAT I AM THE LEGAL OWNER OF, ANT) fN TEND TO
RESIDE IN THE ABOVE DESCRIBED DE L ROPER TY. FINAL r f .r
ln
SIGNATU RE r
OF PERMITTEE
111111111111m . PERMIT VALIDATION OCK ..; CASH
PLAN-CHECK VALIDAN N CK. M.O. CASH
• 3 2 £`r AUG 27 V50 6,5 0 698