HomeMy Public PortalAbout5003 ARDEN DR_Plumbing__ D.._17 25M SETS 11-46 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY �������� '
COUNTY OF LOS ANGELES
WM. J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE _
HEATER RECEIVED BY READY FOR DATH ISSUED
CESSPOOL 1-1 SEPTIC TANK FIRST INSPECTION
AS MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
C NAME ADDRESS
W
m ADDRESS LOCALITY
D NEAREST
'J
d CITY TEL.No. CROSS ST.
COUNTY
CERT.NO. EXPIRES W NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL x MAIL
3 ADDRESS
NORTH O
CITY TEL.No.
--
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
1 ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
. IAM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
(�t11 a ABOVE.
W D
3 OWNER
i
CORRECTIONS
SOUTH
J
DESCRIPTION OF `'FORKz
BATH TUB FURNACE 0
CY
SHOWER DISHWASHER Q
_ LAVATORY �� REFRIGERATOR
ti
1 KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
j SLOP SINK FLOOR DRAIN
+ WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INs�aaTaR'k NAki2
-WATER HEATER DENTAL LAVATORY
ROUGH PLU?S91NP�
METER=,t_GAS SODA FOUNTAIN GAS PIP1NCi, I I 1
OUTL
GAS VENT
C E&SPOOI_
TOTAL NUMBER OF FIXTURES SEPTIC TANK
CES8POOL a SEPTIC TANK SEWER
SI I
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
' DEPARTMENT OF COUNTY ENGINEER PLUMBING
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS J196,7 6A1
FOR APPLICANT TO FILL IN LOCALITY
BUILDING �-j��� +�� NEAREST �p q/
ADDRESS JV 'J CROSS ST, .�Otn�EIQ '4z&'r � 04,
��'-i�l �'f P�� DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY '-t b NEARESTp�7.�� g /017
CROSSST.- O�✓LIQ Z(J.�` �U /MA et
L t:./t/ RELIVED BY Ready for Inspection DATE ISSUED
OWNER
MAIL y y� INDUSTRIAL
ADDRESS S®D3 1jp?jtA1 WASTE APPROV411,
CITY r44)U- � C`I�'V TEL N0.! O 0,21fgo7 INSPECTION RECORD
PLUMBER
ADDRESS
CITY TEL.N0.
0 STATE
LICENSE NO. ❑COUNTY J
PERMIT FEES z
4LIF7EER TYPE OF FIXTURE OR ITEM FEE ED
WATER CLOSET(TOILET) @ 0.80 $ 0:
O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GASSYSTEM....1-----..OUTLETS @ 1.00 HCJ
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE 0 GAS PIPING
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY THAT IROPERLY
AND/OR LICENSED CERTIFY
AS EQUIREDABYPLOS ANGELES REGISTERED
COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDE TIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
f A
OF PERMITTEE...... ......_..............
FINAL V17l�Sa
76A667 DBS 17 1/53