HomeMy Public PortalAbout5013 DOREEN AVE_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department OF of County Ea SAF P L V M B 9 N
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP Z
s i A--1 194 G
PLUMBER RECEIVED BY READY
FIRST INSPECTION
II IS/U��
ADDRESS Haeme�-
BUILDING /
CITY TEL No. ADDRESS
COUNTY LOCALITY ✓ I G
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES �CROSS
ST. A�Q`'kpt•�yy JG�((T/��o--im.
NUMBER TYPE OF FIXTURE OR ITEM I FEE OWNER
MAIL
WATER CLOSET(TOILET) O.5 a ADDRESS
BATH TUB ® 0.5 CITY 1 C TEL No. D. i J
SHOWER O. 4O 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) O.$O APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
11 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.40 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 R ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
JQ OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
OAS 6VSTEM�OUTLET9 O. O SIGNATURE OF hnA n
WATER HEATER Q ❑' T
D PERMITE TT'TT' KKV WWW
SLOP SINK ® Ds0 INSPECTION RECORD
FLOOR BINK
FLOOR DRAIN 0.50
DISHWASHER ® 0.50
DRINKING FOUNTAIN 0.50 G G =F
URINAL 0.50
Q
HOUSE SEWER ® 0.50 I
MISCELLANEOUS (.7
O
APPROVALS
DATE INSPECTOR-9 NAME
ROUGH PLUMBING
GAS PIPING
GAB VENT _
CESSPOOL ® 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1run SEWER
PERMIT 1.00 GAS TEST /� 1
UTILITY CO. NOTIFIED
TOTAL FEE 77271
C-
.4 FINAL �
7GA607 DDS# 17 10/52
76A667A LCE BVBI -4/77
APPLICATION FOR PLUMBING PERMIT
BUILDIN ND SAFETY DIV I N
FOR APPLICANT TO FILL IN IPRINT OR TYPEI BUILDING
rMBIR FIXTURE OR ITEM ® FEE ADDRESS &-Lee�Itir �
WATERCLOSET LOCALITY �, I
/ Nuv*-
NEAREST
BATH TUB CROSS ST.
SHOWER
_3 - OWNER `---
MAIL
LAVATORV�I,4W YL++-O+K• ADDRESS i•/-'�✓�'��
SINK CITY TEL.NO,
DISHWASHER CONTRACTOR )- ,}• C� 0 /-/0
CLOTHES WASHER ADDRESS
46 7
SWIMMING POOL RECEPTOR
CITY TEL NO.
LAWN SPRINKLER SYSTEM STATE LIC.
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM OUTLETS DISTRICT NO. G UP ZONE CESSE BV
a
OUTLETS OVER `� '� O
5 PER SYSTEM INDUSTRIAL U
WASTE APPROVAL
INSPECTION RECORD
U
W
Q-
GO
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE$ jam
TOTAL FEE
Plan check Opp lic t,714'y
APRRQVAC$ DATE INSPECTOR'5 SIGNATURE
Nome
UNDER 51±.4E'WORK `��0��7 4
Address ROUGH PLUMBING
City T,1,No. GAS PIPING
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THATTH E ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER
AND STATE LAWS REGULATING PLUMBING.
IHEREBY CERTIFY THAT I AM PROPERLY REG15TERED AND/OR LICENSED AS PLUMBING FIXTURES
R EOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OFPERM ITTEE - FINAL
PLAN CHECK VALIDATION CK. No. CASH PERMIT VALIDATION cK� N.C. CASH
2 4 O-=ijuv 21 5 U 1 9.5 U
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