HomeMy Public PortalAbout9424 BROADWAY_Plumbing__ 16^16' Do ".' APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY
COUNTY LOS ANGELES
WILLIAM J.OF
LOS FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DIST R A Z N
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PLUMBER /./,Awl F'>i �L! N/a , C d /REEC/E,IVED BY FIRBTp1NBPECTiON DATE ISSUED�
ADDRESS `/�f^D �/-���.i / / C Gi iii TO /T L�JP_
CITY /A� ( /l^U1,unn// TEL Na.�����n��Z''""J��! ADDRE85 �+J7 / I L /•') r(lh .a' ,.i0�/
WOE= NO. /2 / h EXPIRES�� PJV LOCALITY /'PA., ,n 1A C
PERMIT
/
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER /VI C /VI
MAIL /
WATER CLOSET(TOILET) ® 0.90 S C—O ADDRESS
BATH TUB ® 0.50 J CITY TEL No.
SHOWER @ O.SO 1 HEREBY ACKNOWLEDGE THAT I HAVE READ.THIS
I LAVATORY (WASH BASIN) @ 0.50 Sn APPLICATION AND STATE THAT THE ABOVE IS CORRECT
' AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 S[) NO STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
GAB SYBTEMi_OUTLETS @ 0.50 SO OF THE RESIDENTIAL PROPERTY DE�S/CR/I'BED ABOVE
I SIGNATURE OF 1L1.></,/G/� `✓ul"iu,J��
WATER HEATER @ O.SO SU PERMITTEE __
GLOP BINK @ 0.50 INSPECTION RECORD
FLOOR BINK @ O.BO
FLOOR DRAIN @ O.SO /✓m)��frl'Cy y//'rz"'"-""��"'"2J
DISHWASHER @ 0.50 {2—
DRINKING FOUNTAIN @ 0.50 t -7/G S T'Li CT F)i✓L,� GC
URINAL @ O.SOr.6 /Ae J
n��� � Q
HOUSE SEWER @ 0.50 ...f' 6..-`_�a Z
MISCELLANEOUS In
D'
O
APPROVALS
DATE IN..CTOR'S NAME
ROUGH PLUMBING -/O.
OAS PIPING
GAB VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANKS SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT I.DG GAS TEST A
UTILITYCO.NOTIFIED A� / / V
TOTAL FEE
FINAL