HomeMy Public PortalAbout___APPLICATION FOR PERMIT
DEPARTNINT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1WILLIAMJFOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRrO GROUP ZONE PE DMMIT
O
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
Y-l-0
ADDRESS
BUILDING_
CITY TEL NO
ADDRESS
COUNTY LOCALITY
LICENSE NO EXPIRES
NEAREST
PERMIT FEES
CROSS ST
NUMBER I TYPE OF FIXTURE OR ITEM FEE
OWNER
MAIL
I I WATER CLOSET (TOILET) Q O 50 I$ I ADDRESS
BATH TUB Q O 501 I CITY TEL NO
ISHOWER Q O 50I IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) Q O 501
APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING
KITCHEN SINK Q O 50
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q O 50 ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
GAS SYSTEM
R
OUTLETS Q O 50 I
SIGNATURE OF
WATER HEATER Q O SOI I _PERMITTEE
SLOP SINK Q o Sol INSPECTION RECORD
FLOOR SINK Q O 50
FLOOR DRAIN Q O 50 1 1
DISHWASHER Q o 501
DRINKING FOUNTAIN Q O 50 1 1—
URINAL @ O SOI J
HOUSESEWER Q O SOI I Q
MISCELLANEOUS I I 2
0
I
I
I I
APPROVALS
IDATE INSPECTORS NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL Q 1 00 I CESSPOOL
SEPTIC TANK I_ SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1 001 I SEWER
PERMIT I 1 00 GAS TEST
TOTAL FEE
UTILITY CO NOTIFIED
FINAL
10524 DAINES DR
TEMPLE CITY