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7SA667 DBS 17 7-51 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DI R GROUP I ZONE: PERMIT
6 0
PLUMBER� �G� / R CEI BY � ISSUED
READY FOR
,qq �� FIRST INSPECTION
ADDRESS .®�/ 19 .4j') ®��/' U .-o/F/61.Xn.
BUILDING c— O A)a
CITY !.� !� TEL.No.��e)/ r ADDRESS v 9� a ,�A
COON E NO. EXPIRENTY S-7 /�� 9� LOCALITY O /O 6v � �0 e�J�'
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNERMAIL
/T
6aADDRESS
WATER CLOSET(TOILET) � 0.50 $
D BATH TUB @ O.SO CITY TEL No.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
p AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK Q 0.50 AND STATE LAWS REGULATING PLUMBING.
1 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
/! LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OOF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM UTLETS 0.50
SIGNATURE OF
WATER HEATER 0.513
PERM[
SLOP SINK 0.s0 INSPECTION RECORD
FLOOR SINK 13.50 G,.d , w 7 / �/
FLOOR DRAIN @ 0.50 G�+J/ (t.{i/moo
DISHWASHER 0 0.50 " -44
DRINKING FOUNTAIN @ 0.50 -+ /���'7' - �a ^�O ! Z fie'
URINAL 0.50 /_ Api�l i.S✓U �� �.S
HOUSE SEWER 0.50
� �� Z_
MISCELLANEOUS O
e✓ .� F�f� ems' 1�l�.r'""
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
G�
GAS PIPING EG/,
GAB VENT
CESSPOOL @ 1.00 CEBBPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1.00 SEWER
PERMIT • . . . 1.00 GAS TEBT
UTILITY CO.NOTIFIED �./I 9
TOTAL FEE �� FINAL v' J