HomeMy Public PortalAbout5418 CAMBURY AVE_Plumbing__ 7USST n S-So KD APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMITNO.
'1 n ;< 86037_ 7
PLUMBER VALLEY '�' - RECEIVED BY READY FOR DATE ISSUED
O ,_ FIRST INSPECTION 2-
ADDRESS H3OO EA � ! p�I"
BUILDING
CITY ROSEMEAD TEL. NO. AT. 7-97IQ ADDRESS 7 b
COUNTYtt
LICENSE NO. 93M EXPIRES 6.30- 15 LOCALITY ./JT'✓
NEAREST
.PERMIT FEES caoss sr.
g_lot�IL
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER LS /n
WATER CLOSET (TOILET) 0 0.50 S ISO ADDRESS .� dynYll /Ll —llY1
BATHTUB p 0.50 So CITY
SHOWER p 0.50 1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) 6D 0.50 S6 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK p 0.50 S6 STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
7 LAUNDRY TUB OR TRAY p 0.50 5.6 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
OF THE R ESI D ENTIAL•PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS p 0.50 ✓//JJ,� //,�
'` SIGNATURE OF
I WATER HEATER p 0.50 '` PERMITTEE ��'N��II// ♦// /� �i
SLOP SINK p 0.50INSPECTION RECORD
FLOOR SINK p O.SOI
FLOOR DRAIN p 0.50
DISHWASHER p O.50I
DRINKING FOUNTAIN p O.SOI
URINAL A 0.501 J
HOUSESEWER p 0.50 Q
Z_
MISCELLANEOUS I 0
_I 0
I
I Imo_
I APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING _
l� GAS PIPING
_ GAS VENT
CESSPOOL p I.Do CESSPOOL
SEPTIC TANK: SEPTIC TANK J
DRAIN I ) PIT ( ) p 1.0OI I SEWER
PERMIT . I LOO GAS TEST /
UTILITY CO. NOTIFIED
TOTAL FEE
S��I`O FINAL
]6N66]C (IV-6t7.) - 7/75 -
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ,y
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
LOCALITY i
WATER CLOSET
NEAREST
BATH TUB CROSS SL titer
SHOWER OWNER N CJ�1/e
LAVATORY MAIL
ADDRESS
SINK CITY TEL. NO.
DISHWASHER CONTRACTOR
.�G
CLOTHES WASHER `^
ADDRESS
SWIMMING POOL RECEPTOR
CITY TE L.
LAWN SPRINKLER SYSTEM
TATIE" LIC
WATER HEATER SIC EN SE N � CLASS �� y
d
GAS SYSTEM OUTLETS DISTRICTu GgOUP ZONE OSE BV
OUTLETS OVER !1
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL yVj
LL.
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
Plan check applicant �'U
Name APPROVALS DATE INS Pec TDR'S AIaNATunc
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. _
I HEREBY CERTIFY T AM PR PERLT REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REOUIR BY 05 pNGE ES COUNTY PND STATE OF GAS TEST
CALI FO pNIA OR TXA AM E LEGA OWNER OF, AND INTEND TO
RESIDE IN THE ABO E DESCR BED AE51 ENTIAL RO PERgT. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITT FINAL
N $[
PLA NCHE_CK LIDATION CK. M?D.' o CASH ° PERMIT VALIDATION CK. M.D. CASH
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