HomeMy Public PortalAbout9082 BROADWAY_Plumbing__ 76A667 - CE817 5/70 `\_/ V l/1./✓'"
iL ..JR`
' ,. APPLICATION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION F
DING
JOHN A. LAMBIE, COUNTY ENGINEER' ESS (l COLEMAN W. JEN KINS. SuPT. OF BUILDINGALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
I WATER CLOSET 1 'p OWNER
MAIL
BATH TUB 1. 0 ADDRESS D p
SHOWER 1, o CITY G/. TEL. NO.
LAVATORY 1. p
^j CONTRACTOR LA
14
SINK 1. 0 ADDRESS
C /
DISHWASHER I.Fn CITY TEL. NO�'2., /t)
CLOTHES WASHER {. p STATE LIC JJ
LICENSE NO. CLASS
1 SWIMMING POOL RECEPTOR 1. 0 - -- - ---
DISTRICT NO. GR P ZO E P SED B
LAWN SPRINKLER SYSTEM 2. 0 A
` WATER HEATER 1. 0 INDUSTRIAL
WASTE APPROVAL ^
GAS SYSTEM OUTLETS 1.5 INSPECTION RECORD QVC
OUTLETS OVER
I5 PER SYSTEM .3 O
z
Plan check fee 25% of above. See,reverse.
PLUMBING PERMIT ISSUING FEE.9 00
TOTAL FEE 1>
APPROVALS DATE I NSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
/ v
Name ROUGH PLUMBING
Address GAS PIPING
Cit GAS VENT
X "Tel. No.
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND
STATE THAT THE ABOVE Is CORRECT AND AGREE E LATING PLUMBING FIXTURES
WITH ALL COUNTY OROINAHCCE AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AHD/OR UTILITY CO.NOTIFIED
LICENSED AS REOUIRCO BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN. THE ADDY EEC IBED RESIDENTIAL P FINAL
SIGNATURE i
OF PERMITTE JACK R. ALLEN, SUPERVI G M HANICAL ENG'R.
_
PERMIT VALIDATIO cK. M.D.' CASH
PLAN CHECK VALIDATION CK. M.O. CASH -
L;�Co 2 a F. uCl 1 F3 5 13. /�
D.B.S.-17 25M SETS,,6-46 ' ' - - 'APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY m
COUNTY OF LOS ANGELES
Wm. J. FOX, CHIEF ENGINEER
NATURE OF INSTALLATION o1sTRlc NO. G OUP zo E PERMIT NO.
T-
ROUGH FIXTURES. COMPLETE -
HEATER CESSPOOL- II SEPTIC TANK RECEIVED BY READY FOR _ DATEIBBU D
r FIRST INSPECTION
GAB- MISCELLANEOUS
4
APPLICANTFILL JN HEAVILY OUTLINED PORTION LY. �I ,,-,,
JOB _
'¢, NAME'JV ADDS
W
® ..ADDRESS
E LOCALITY <-
J _ NEAREST . .
y.
CITY"
/ � 'TEL.No. CROSS ST: +"
COUNT ...
CERT.No. ' E%PIKES E NAME.
LOCATION OF SEPTIC TANK, OR CESSPOOL` ~3' MAIL
NORTH O
I - CITY - TEL.No.• ••
1 AM THE LEGAL POSSESSOR OF THE. ABOVB LOB
ANGELES COUNTY CERT I FIM OF OUALI (CATION.
PLUMn¢R
f AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS
SOUTH 5 W
DESCRIPTION OF WORK
BATH TUB FURNACE J
IL
SHOWER DISHWASHER - 7'
O
LAVATORY REFRIGERATOR
KITCHEN BINK WATER SOFTENER
FLOOR BINK SANDTRAP `
GLOP BINK FLOOR DRAIN
WASH TRAY ' URINAL APPROVALS
* LT
WATER CLOSET DRINKING FOUNTAIN
DATE IN¢P¢CTOR'B NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUNGING" I
METER GAG 'SODA FOUNTAIN GAB PIPING
OUTL
GAS VENT I I'
•'CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
CESSPOOL -REPTICTANK 'SEWER I I.
UTILITY CO.NOTIFIED '
FEE -. . . . FINAL.