HomeMy Public PortalAbout9404, 9400-9404 BROADWAY_Plumbing__ 96.669 17 1'-.9 - ;' XPPLICATION FOR PERMIT
e/pEPARTOF BUILDING AND SAFETY
COUNTY
COUNTY F LOS ANGELES
WILLIAM J.
FOX, CHIEF ENGINEER
D R ,. O. QR O P ON PE MIT NU
FOR APPLICANT
TO FILL IN
%1
PLUMBER J?10 iV .I `�" ST I RECEIVEq BY READY FOR 1 /pDATE ISSUED
ADDRESS RST INSPECTION
CITY q/ �• /TEL No. 1/O 'T.�J II^ ADORE" D �J
COUNTY ) LOCALITY .rO PJ
LICENSE NO. / EXPIRES
NEAREST
PERMIT FEES Caoss ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) @ 0.50 s ADDRESS
BATH TUB @ 0.50 CITY TEL. Na:
SHOWER @ 0.50 1 HEREBY ACKN LEDGE THAT I HA E READ NI9
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
_ OF THE RESIDENT 1 AL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OOTLET6 @ -0.50 ^�
SIGNATURE 1/
WATER HEATER @ 0.50 PERMITTEE
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK @ 0.50
Y FLOOR DRAIN @ 0.50 1
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50 ^�O /N3QBGT�GJy 6�JHOl�'
URINAL @ 0.50 Q
HOUSE SEWER @ 0.50_ Z 9/S-z� _
MISCELLANEOUS3
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7-117044 J 1" ' APPROVALS
DATE
J / IN9PCCTOR'9 NAME
'P , ROUGH PLUMBING I�//7/.Y� 1,44
" .✓ T SII
GAS PIPING
/O ,(�✓
GAS VENT
CESSPOOL @ •I.00 CESSPOOL
SEPTIC TANK• SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT 1.oD GAS TEST
�j UTILITY CO.NOTIFIED
TOTAL FEE S T
FINAL
' c
76AB67-CO17 M9
APPLICATION FOR PLUMBING 'PERMIT,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DMSION BUILDING
IOHN A. LAMBIE. County EnqInger ADDRESS
CASSATT D. GRIFFIN. Supt of Building
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSES MAIL
BATH TUB ADDRESS l
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR C(
SINK ADDRESS
DISHWASHER C17Y TEL NO. Y12
STATE Er
LAUNDRY TUB EGISTMRAT ONSNO. G31, 02.0 COUNTY
CLOTHES WASHER DI�yST�RICT NO. GRO�P� ZONE P OCESSED BY
WATER HEATER �J
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
2�f �
v -
O BI.OD PER ITEM
OR FIXTURE $ APPROVALS DA/TE/ INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK n'(pZ /l�j'/l p�Y ydByy
TOTAL FEE L-1100 ROUGH PLUMBING –/ .. /•�/
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY a GAS VENT /flit. �-lI `; M
WITH ALL PLUMBING, COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER / YYNrl.I1nY,IlYAY
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND7ORLPLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFAS TEST PI A/P
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIOENTI PROPERTY. TILITY CO. NOTIFIED
SIGNATURE 11y
OF PERMITTE NAL 2-L� "YH.N(l.YOrJ
Or VALIDATION ROBERT A. WOOD,
gg. M.D. wsN SUPERVISING MECHANICAL ENG'R
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