HomeMy Public PortalAbout9636 BROADWAY_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING a • 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICAON
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS r
• /
FOR APPLICANT TO FILL IN LOCALITY
NEAREST
BUILDING CROSS ST.
ADDRESS
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,p 1 DISTRICT 10. GROUP ZONE ERMIT NO.
LOCALITY TC M A jC
NEAREST
CROSS ST. RECEIVED BY R"dy for lnsaeatlon OATEISSUEDD
OWNER / /V K / 'e. // ' � S D
MAIL t INDUSTRIAL
AO DRESS 9G e 4 / p-J (.t! G.f WASTE APPROVAL
CITY J- ep p TEL.ND. I INSPECTION RECORD
PLUMBER ( /, M eC I 1.) I Q s0�-� ern °ate 4m Kb &'f-
1 / / .1 /I / i� / 0 LC(I 8� /
CITU / ZN PIt �• TEL.NO. /rr—p ry 7 7eJd
State Contractor's '
License No. Q /•� 1 9 / Class Q_ L�
L.A.County Contra"'s J
Reglstratlon No. / O 3 b Z
PERMIT FEES E3
NUMBER TYPE OF FIXTURE OR ITEM FEE a
C3
I WATER CLOSET(TOILET) @ 0.80 S
I BATH TUB @ 0.80 0
SHOWER @ 0.80
/ LAVATORY (WASH BASIN) @ 0.80 R' D
I KITCHEN SINK @ 0.80 d
/ LAUNDRYTU BORTRAY @ 0.80 .4
SLOPSINK @ 0.80
FLOOR SINK @ 0.80 _
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80 _
GAS SYSTEM.—A---OUTLETS @ 1.00 _� O
/ WATER HEATER @ 1.00 1 Q
MISCELLANEOUS APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT { 1 00 ROUGH PLUMBING --
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS 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 I /
AND/OR LICENSEEBY D IFY THAT I AM AS REQUIRED BY PROPERLY REGISTERED
LOS ANGELES GAS TEST
ANO STATE OF CALIFO NIA 0 THAT 1 AM THE LEGAL OWN.
ER OF THE ABOVE D/ RIB RES NTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE... -- _.._.. ..__._ ^_.._._..._._... FINAL
7GA667 DBS 17 6/84