HomeMy Public PortalAbout8914 BROADWAY_Plumbing__ 7exee7 17 B-BO APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
I
COUNTY OF"LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP�Z"O`NE PERMIT NO.
r_� 6 7 b
PLUMBER R EIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS
'WILD]
ING A /JJ A s t
CITYer� TEL. NO. ADDRESS oc�
COUNTY LOCALITY
LICENSE NO. - EXPIRES
NEAREST `
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER ^y'
MAIL
WATER CLOSET (TOILET) @ 0.50 $ I ADDRESS f!)40 <
IBATH TUB @ 0.501 I CITY U. TEL. NO. /K.0-w—f—
I SHOWER @ 0.50
�— I HEREBY ACKNOWQAEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.501 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE. TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ 0.501
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY
-- @ 0.501 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
_I GAS SYSTEM OUTLETS • @ 0.50 I OF THE RESIDENTIAL�,.fPJROPERTY DESCRIBED ABOVE.
• — WATER HEATER @ O.50 1 SIGNATURE OF ►( 11 _ �t f A
PERMITTEE �W�"�� ✓W�
SLOP SINK @ 0.501 INSPECTION RECORD
,rc,y J FLOOR SINK @ 0.50
y J FLOOR DRAIN @ 0.50
DISHWASHER @ 0.501 .4In-,� °'"����`�-I ��9tr-T"y
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 v ,J
IHOUSE SEWER @ 0.501 Q
MISCELLANEOUS i i Ofd rj�qU�
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APPROVALS
' DATE INSPECTOR'S NAME
ROUGH PLUMBING e
GAS PIPING
GAS VENT I T kiT
CESSPOOL @ 1 00 I CESSPOOL /T _
SEPTIC TANK: I SEPTIC TANK p `,
• I DRAIN ( ) PIT ( ) @ 1.00 SEWER r
PERMIT 1:0. GAS TEST
TOTAL FEE
UTILITY CO. NOTIFIED
$
i FINAL �I
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