HomeMy Public PortalAbout8616 WORTHINGTON DR - Plumbing - 1960-04-07 78A887-CE817-8-58
02 APPLICATION F'OR .•PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTbUM OF COUNTY ENGI NEER
BUILDING AND SAFETY DIVISION As �/ ®�%�/� j
TORN A. LAMBIF.. County es
SATT D.GRMW.Sup t o! Wilding LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS-ST. 4j�
NUMBE FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
RATE TUB ADDSSSB
SHOWER CITY TEL.NO.
LAVATORY CONTRACTOR FONTANA P(.Um
s m ADDRESS 13329. E. E
DUMWASEER CITY Cify of IndusfneM E95-"2
CONTBACTOws
® LAUNDRY TUB REGMTRATION NO. #96496 COUNTY
CLOT=WAR DISTRICT NO. GROUP ZONE P CESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
@ OB TUR PER O EM $ DATE INSPECTOR'S SIGNATURE
UNDER r C�RK L/ - D
PERMIT $ .2100 ROUGH PLUMBING )
TOTAL FEE .j ® GAS PIPING oil
LDESCRIBED
BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION OAS VENT S
E THAT THE ABOVE 13 CORRECT'AND AGREE TO COMPLY HOT WATER HEATER
L COUNTY ORDINANCES AND STATE LAWS REGULATING
G. PLUMBING FIXTURES 7-7-40 `
BY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST �l `
AS REQUIRED B LOS ANGELES COUNTY AND STATE OF
IA OR THAT I THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED -6 V C i
D RESIDEN A ROPEIGNATURF
MITTE FINAL
®p ALIDATION SUP ERV S NG MECHANICAL ENG•R
CK. B.0. CUB
•8 9 5 0 S APR, 7 5 A 13.0 0
76A,667 (CE-817)-4/72
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: ADIDRESS
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY �', .�& L G
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER' FIXTURE OR ITEM ® FEE
WATER.CLOSET 1.75 OWNER
MAIL
BATH TUB 1.75 ADDRESS
SHOWER 1,75 CITY TEL. NO.
LAVATORY 1.75 CONTRACTOR V T G t&v
SINK 1.75 ADDRESS/t7/ 4 L f. 1�7s64[
DISHWASHER, 1.75 CITY,42 Gkd to TEL. NO. Kfi�6-714
CLOTHES WASHER 1.75 STATELIC 3
SWIMMING POOL RECEPTOR 1.75 LICENSE NO.90 CLASS l
DISTRICT NO. P N PRD.CESSED BY
LAWN SPRINKLER SYSTEM. 1.75
WATER HEATER 1.75 INDUSTRIAL y
WASTE'APPROVAL n,
GAS SYSTEM OUTLETS 1.75INSPECTION RECORD' v
OUTLETS.OVER
5 PER.SYSTEM .30 C
W
Ci.
_ rn
. Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 8 00
TOTAL FEE
APPROVALS DATE INSPECTO R'9 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name v �C, aj ar' ROUGH PLUMBING.
Address/0 �. C/ve 0&/ GAS PIPING
City,4a2C A_ Te.l. No:ilf 6��. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REIIUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR 1 AM THE LEGAL OWNER OF, AND INTEND TO _
RESIDE IN TH BOVE SCRIBED RESID RTY• FINAL
SI GNAThim U r
OF PERM
PERMIT VALIDATIONCK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH K.
L4,o0694 JANe.Dr1 5 A 8.25~ V
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