HomeMy Public PortalAbout9650 BROADWAY_Plumbing__ D.S. 17 25M SET. 12=e2 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
Wm. J. FOX, CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE �` —• 1� J��
RECEIV D BY READY FOR DATfi ISBU ED
HEATER CESSPOOL SEPTIC TANK � T. FIRST INSPECTION
GAB- MIBCELLANEOUB VY, •G
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB 41
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CITY 7n TEL.No. CROSS ST.
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CERT.No. EXPIRES K NAME
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LOCATION OF SEPTIC TANK, OR CESSPOOL a MAIL
3 _ADDRESS
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CITY TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOO
ANGELES COUNTY CERTIFIC: OF OIJ�LIFICATION}J`
SAV/7rT.iROPE obO' ESC
I AM THE LEGAL OWNER OF/THE PROPERTY DESCRIBED
q r, ABOVE.
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OWNER
/ CORRECTIONS
SOUTH I
DESCRIPTION OF WORK i
` BATH TUB FURNACE
R'
SHOWER DISHWASHER D
'AVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SANDTRAP
SLOP SINK FLOORDRAIN c
WASH TRAY URINAL APPROVALS''
WATER CLOSET DRINKING FOUNTAIN
DATE IN8P60TOP'B NAME
WATER HEATER DENTALLAVATORY ROUGH PLUMBING I I
—METER—GAS SODA FOUNTAIN
OUTL GAS PIPING I I
GAS VENT I I
CESSPOOL I
1-TOTAL NUMBER OF FIXTURES SEPTIC TANK
�CESSPOO, REPTICTANK /.60 SEWER I
$
TOTAL FEE /� pO UTILITY CO.NOTIFIED I(� :_/� /✓ I I ��p/,�/I� �✓ ,
�Ioo FINAL U / / l VV iee