HomeMy Public PortalAbout10787 BLACKLEY ST_Plumbing__ EdiPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
i COUNTY OF LOS ANGELES BUILDING
WILLIAM d., FOX. COUNTY ENGINEER ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
NEAREST
BUILDING �+ CROSS ST.
/0 (J
ADDRESS �, I�
—T— DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY /7
NEAREST ~
CROSS ST. C R EIVED BY Ready for Ineveollon DATE ISSUED
OWNER I
MAIL INDUSTRIAL
.ADDRESS a WASTE APPROVAL
CITY TEL.N0.
INSPECTION RECORD
PLUMBER
ADDRESS �j������
CITY TEL.NO.
Q STATE
LICENSE NOrCOUNTY ' OleJ
"PERMIT FEES a
z
4UMBER TYPE OF FIXTURE OR ITEM FEE ue
T WATER CLOSET(TOILET) @ 0.80 3910
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
GAS SYSTEM........ ----OUTLETS @ 1.00
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVAL
ATE IN SPECTOR'S,SIGGN�ATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1HAVE 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 CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST .I
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED/RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED _
SIGNATUREy I
OF PERMITTEE!.-- ... _.... ......_.
FINAL
76AC67 DBS 17 r1l. 1.
_c
S.17 25M BETS 1-419 APPLICATION FOR PERMIT
BUMTMENT OF BUILDING AND SAFETY '
COUNTY OF LOS ANGELES
WM.J. FOX. CHIEF ENGINEER PLUMBING
NATURE OF INSTALLATION DISTRICT NO. GRO ZONE PERMIT NO.
Lor l '
ROUGH FIXTURES COMPLETE
HEATER CESSPOOL -I SEPTIC TANK RE !l IV D BY READY FOR DATE IS! ED
�y FIRST INSPECTION
A8 MIBCELLANE UB \
APPLICANT FILL IN HEAVILY O LINED PORTION ONLY
JOB
a NAMEOlWg:pADDRESS
W
® ADDRESS �Q E QjyN� LOCALITY
J NEAREST
L CITY TEL.NO. CROSS ST.
COUNTY ..
CERT.NO. EXPIRE x NAME a,16
LOCATION OF SEPTIC TANK, OR CESS 00 MAIL 3 ADDRESS
NORTH O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOB
ANGELES COUNTY CERTIFICATE FALATION.
�'
PiLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
�qABOVE.
W D
1 OWNCR
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK a
Z
BATH TUB FURNACE
ROWER DISHWASHER D
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN pATil VNTOR'@ NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METERtGAB SODA FOUNTAIN
OUTL 6A9 PIPING
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC_TANK
CESSPOOL SEPTIC TANK SEWER
s
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL