HomeMy Public PortalAbout9619 BROADWAY_Plumbing__ ' DEPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES I BUILDING U'/ /�
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS / \>O
FO PPLICAN TO FILL IN LOCALITY awe e— J
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BUILDING CREAREOSST
$ST.
ADDRESS
DISTRICT NO. GROUP ZONE' ph PERMIT N0./,
LOCALITY LJ� �NEAREST
CROSS STRECEIVED BY Ready for kspec8on DATE ISSUED
OWNER /�M+'✓I d.��. /�7 /�
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ADDRESS ) WA
CITY N EL.NO. INSPECTION RECORD
1
PLUMBER l4
ADDRESS
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CITY TEL.NO.
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LICENSE NO. J U A ❑COUNTY" J
PERMIT FEES' a
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NUMBER TYPE OF FIXTURE OR ITEM FEE ur
WATER CLOSET(TOILET) @ 0.80 $ O:
BATH TUB ao 0.80
SHOWER @ 0.80
LAVATORY (WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOOR SINK @ a 8
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM.....I.....OUTLETS @ 1.00 /
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT 5 n1 00 ROUGH PLUMBING
TOTAL EEE 9,1 0 0 GAS PIPING
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GASVENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOTWATERHEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR'L)CENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE.OF CALIFORNIA OR THAT I AM THE LEGAL OWN. -
ER OF THE ABOVE DESCRIBED RRESID/Ef1 SIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE !! ♦/B �_ __ ''�``
OF PERMITTEE-:._...... .._....... �_.F... .. .4.........._........__..... ............ FINAL Jf3��"r° TTJ.f�%IGds✓
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