HomeMy Public PortalAbout9640 BROADWAY_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING /) l
WILLIAM J. FOX. COUNTY ENGINEER ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
ILDING l y�
NEAREST
BUb / Iy QhOb. Iw b CR`SSST.
ADDRESS / I/ T d
/ DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY e Yl / e 5 -r
NEAREST
CROSS ST. RECEIVED BY Ready for lnaaeation DATEISSUED
OWNER B I At N 1 P.,
MAIL L 1� INDUSTRIAL
ADDRES.S/ AG I� 1Se. F- �I.fJ �. ✓ WASTE APPROVAL
CITY le rA 1gle, /!,LJTEL.NO. Fl �'l �_�� INSPECTION RECORD
ADDRESS 1I 1 )/ 1 N -t 10,w!?
CITY Tp m P le TEL NO. re k 7 7
State Contractor'sA G:.
License No. `Q B Q Class
L. A.County Contractor's ` J
Registration No. / O Q
Z
PERMIT FEES
NUMBER TYPE OF FIXTURE OR ITEM FEE
0
WATER CLOSET(TOILET) @ 0.80 3
I
BATHTUB @ 0.80 J Sf D
SHOWER 0 0.80
LAVATORY(WASH BASIN) @ 0.80 D
1 KITCHEN SINK @ 0.80 Q
LAUNDRY TUB OR TRAY @ 0.80 R O
SLOPSINK 0 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80 _
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80 _
GAS SYSTEM...--- ._OUTLETS @ 1.00 p
WATER HEATER 0 1.00
MISCELLANEOUS APPROVALS
DATE INSPECTOR'S SIGNATURE
_ UNDER SLAB WORK I
p
PERMIT $ 1 00 ROUGH PLUMBING H IIT- `�'I Na�r.....•.�^•-- .
TOTAL FEE O V GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREEHOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY PR THAT,��IILOS ANGELES COUNTY GASTEST
AND STATE OF CAAM THE LEGAL
ER OF THE ABOVELD O CRIA D RESIDENTIAL PROPERTY.OWN UTILITY CO.NOTWI ED 0. L
SIGNATURE
OF PERMITTEE..r.(Js..._ FINAL
7GA667 DBS17 6/54