HomeMy Public PortalAbout9422 BROADWAY_Plumbing__ DBS-17 10-55 APPLICATION FOR PLUMBING PERMIT
DBS-17
OF BUILDING AND SAFETY
Department of County Engineer- _
County of Los Angeles BUILDING V /
'JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS Z Z f �R -ef epl
CASSATT D. GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER `Je DISTRICT NO. GROUP Z�ON,[E� READY Fon Ins PEci tan '
MAIL �TI
ADDRESS
.-/ I
CITY TEL. NO 2-a,91INDUSTRIAL
WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY L. NO.
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 S
BATH TUB @ S1.00
SHOWER @ 51.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ S1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER@ 51.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTORS SIGNATURE
_1
UNDER SLAB WORK A
PERMIT S 1 00 ROUGH PLUMBING II II
— GAS PIPING K '�� �n Y
TOTAL FEE
GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AB
AND STATE THAT THE ABOVE ICORRECT AND AGREE COMPLY HOT WATER HEATER
p
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST p'115 y�j ' ( ,4`1A
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF -
CALIFORNIA OR THAT I HE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDEN IAt,,P1lC1PERTY.
i/
SIGNATURE 'w
OF PERMITTE 2 --- - FINAL
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A. WOOD. CHIEF PLBG. INSPECTOR
apt 9 0 3 8 JUN 1 O 3 2.0 0 �
n.ns.-aa 25M saxs s•as APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY 51
COUNTY OF LOS ANGELES � �� U
WM. J. FOX, CHIEF ENGINEER
NG
NATURE OF INSTALLATION I DISTRICT O. GROUP O E /5PE IYNO.
ROUGH FIXTURES COMPI.ETE' / /J O _ '�>
HEATER CESSPOOL I SEPTIC TANK RICnE^IV_ED BY READY FOR DATEISSUED
1--:1 MISCELLANEOUS Wee / FIRST INSPECTION
AB
.. _ . . .. -
//AJJPPLIIIC�ANTFILL IN HEAVILY OUTLINED PORTION ONLY
300 C
NAMEr (,(9/. ,{�1.9?//�Gt�(i/iYY ' ADDRESS I
8 ADDREBG/ 2 dNl// LOCALITY�YJL%fiAD C.�A�
y CITYi/6/lilr/�// �B/TEL.No. CRO BBT. y O
/J /L// /) )
CERT.NO. [// v
COUNTY , //E%PIREB W NAME`'/Y�--
�
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL/.
ADDRESS •+l�A w
NORTH O
CITY TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICAA/TT[E,OFF�QUALIIFICA_TION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
A
D
3 N OWNER
y .CORRECTIONS
SOUTH J
DESCRIPTION OF WORK z
BATH TUB FURNACE L7
Ir
ROWER ' - DISHWASHER O
LAVATORY. REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR BINK SANDTRAP
GLOP SINK FLOOR DRAIN
WASH TRAY URINALFGABVENT .
PPROVALS
WATER CLOSET DRINKING FOUNTAIN '
DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORYI 'I
METER-GAB RODA FOUNTAIN I I
OUTL
I
CESSPOOL Ips -'a-yr p�
TOTAL NUMBER OF FIXTURES SEPTIC TANK I I
CESSPOOL SEPTICTANKS/ SEWER-11I I
UTILITY CO.NOTIFIED I I
TOTAL FEE .
FINAL