HomeMy Public PortalAbout9626 BROADWAY_Plumbing__ DEPARTMENT OF COUNTY ENGINEER ` PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
LOCALITY
FOR APPLICANT TO FILL IN NEAREST T /
BUILDINGIJs7�` T�� y CROSS.ST. / C.. /�' ✓
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y-J`' (�/ Y J DISTRICT NO. GROUP 20NE PERMIT NO.
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ADDRESS WASTE APPROVAL
CITY 1UALLIN 'S TEL.ND. INSPECTION RECORD
PLUMBER r L U M B I
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ADDRESS S E R V I C E
ciMl EMPEROR AVE. - SA!!M^S..ABRIEL - AT, 7.34
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LICENSE NO. /� 7 ❑STAT NTY J
YYY T PERMIT FEES a
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YIJIAi.ER TYPE OF FIXTURE OR ITEM FEE ul
WATER CLOSET(TOILET) @ 0.80 $
r/� O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOPSINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80'
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GASSYSTEM..... .......OUTLETS @ 1.00
WATER HEATER @ 1.80 / �)
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDERSLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE epO GAS PIPING Arlk 11_ cl
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES �n .
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST / SsAflfPlt --ate-�
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN.
ER OF THE ABOVE DE IBED RESIDEN AL P PERTY. UTILITY CO. NOTIFIED
SIGNATURE ///J F
OF PERMITTEE.' _. ... . ._ .. ....! -.--. .._....._..__. FINAL �.'Ic f , .ur
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