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HomeMy Public PortalAbout5221 EL MONTE AVE_Electrical__ 76A663-CE806 10-62 (/'-�1P11 LS��7!/�1��©I1 V FOR `L-�LYa LS V�'U��V�AL� RtlVll��' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER, BUILDING BUILDING AND SAFETY DIVISION ADD EBB U JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY 4�7t-fPl—L !`T o .NEAREST, FOR APPLICANT TO FILL IN CRoss sr. -s RECEPT. TOTAL NO. EACH FEE - - OUTLETS FIRST 20 $2O $ OWNER 3 0 s e4 LtP_c,h LIGHT MAIL - tQ� ADD'L swlTcrl. 9 OVER 20 .10 6• ADDRESS / TOTAL "�� CITY /b.74 Ci TEL. NO. LIGHTING FIRST 2O .20 r✓7J FIXTURES. ��.� _ OVER ZO ZZ •f0 .�Ll ELECTRICIAN` ' �l..�Ld �L[:.�.'1"r. Co RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS `✓? � ' U-C.L GARB.DISP.' - STA.COOK C CITY �JAAV i74 jq t4 - TEL.NO. 64 Ity 3s 2 .f DISHWASH. AUTO.-WASH. STATE ^ LICENSE NO. SPACE HTRS. STA.APP.(I/z H.P.MAX.) ..50 - MOTORS: .,.OVER NOT OVER H.P. DISTRICT N,/ I.GfOUP ZONE PR SED BY O 1 1.00 1 3 INSPECTION RECORD a 3, - 8 2.00 O 8 15 "2.50 V _ Is 50 3.00 - O 50 100. 5.00. a r SIGNS: NO.TRANS. NO.LAMPS z SERVICE 0.60OV-NOT OVER 200A 3 1.00 I SERVICE 0-600V-OVER 200 A. 2.00 - '• SERVICE OVER 600V - 5.00 ri NIISC. .M PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 - - TOTAL FEE $ w ��o 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS - DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ ELECTRICAL WIRING. - WIRING y" G 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED.AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF O FIXTURES ' CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED / r, OF PERMITTEE 1 6ALIDATION ARTHUR C. VEIT .SUPERVISING ELECTRICAL ENGINEER' CK MO CASH ' s3s� 9 ao 3 ®.80N � DSS SSA 11-46 p91��1�7p1rg� BM 7�,�T,ry ®�7� �i APPLICATION FOR PE DEPARTMENT EN IL OF HBaJIIHiIlYING AND S ESisi EJlLtg lY S . COUNTY OF LOS ANGELES ELECTRIC: WM. J. FOX CHIEF ENGINEER a NaME DISTRICT NO. GROUP ZOITE PERMIT NO.1 ADDRESS CITY y_ TEL.NO.,#o S RECEIVED BY READY FOR DATE ISSUED J COUNTY [ // ��y FIRST INSPECTION . W CERT.NO. IUZ lJ EXPIRES APPLICANT FILL-IN H.EAWLt OUTLINED PORTION ONLY JOB DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY v LOCATION BY ROOMS NEAREST 3. � 6..� LIGHT OUTLETS SW. PLUGS FIZT ` CROSS ST. CIRCUIT A B C I D I E F G IH I w NAME MAIL { ADDRESS /� ✓/�� O CITYTEL.NO. 7Qd/IG/� 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. H A "L OWNER OF THE PROPERTY DESCRIBED CORRECTIONS 'J — Q Z_ t7 E O TOTAL NO. OF OUTLETS $ O APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF-SIGNS TRANS. $ WIRING NO. OF RANGES OfF0HZMaS $ Z FIXTURES MISCELLANEOUS $ POWER PERMIT FEE $ o-G UTILITY CO.NOTIFIED / y_ TOTAL FE O FINAL �Y ' ""—, L, R %N r W-T cz 76A663-.CE806 ;.6%72'_.� AMMANFOR ELECIM, PUNT � - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER Joe BUILDING,AND SAFETY DIVISION ADDRESS hl LOCALITY - FOR APPLICANT TOFILLIN NEAREST spa*• �/ p CROSS ST. T . "OUTLETS NO. EACH FEE OWNER OR -. S $ FIRM NAME RECEPT-.`. - MAIL _ FIRST 20 ADDRESS ~ LIGHT TOTAL' .25 .4 OVE"R 20 ,CITY _ SEL. NO. SWITCH- .10 �1 'PLAN CHECK LIGHTING FIRST 20 ,25` APPLICANT TOTAL COVER 20 ADDRESS - - •, FIXTURES - .IO _ RESIDENTIAL APPLIANCES CITY TEL. NO.: - ..,PRMIT, RANGE DRYER, ,WTR. HTR._ - APEPLICANT-: --� - / ✓ STA.,COOK. DISP,. .F...A.U. ADDRESS �j SPACE.HTR: 'AIR COND." ) CITY TEL. NO_� CLOTHES WASH. -DLSHWASH.- LICENSE 0 CLASS: REG. NUMB R FAN OTHER 1.00 _ 1 HEREBY ACKNOWLEDGE 'THAT I HAVE READ THIS APPLICATION AND STATE THAT-THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ IND. HEATERS, ETC., " HP: KW..K'V.A. ELECTRICAL WIRING. SIZE &"TYPE 'OVER TO - IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 _ 1 X00: LICENSED AS'REQU IRED BY LOS ANGELES..C.OUNTY,AND STATE.OF CALIFORNIA OR. THAI i AM THE LEGAL-,OWNER OF THE ABOVE _ 1 - 1D 3.00' I DESCRIBED REST DENTIAL PROPERTY. 1 4. CD PERMEE 10 — 50 5.00 Ctj ,. V 50 100 10.00 DISTRICT NO. "' PROCESSED BY .W 1 O0-- 500-_.. 15.00. �'.J"f N S` IGN�GAS.. SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'SSIGNATURE TUBE, OR, - - MARQUEE' ADDITIONAL_CIRCUITS I•.00' TEMP. POWER POLE I SERVICE NOT OVER600.VOLTSOR200AMP 3.00 UNDERSLAB WORK+ - SE,R'VICEOVER600.VOLTSOR200AMP ' • 10.00, ROUGH 'CONDUIT TEMP SERVICE, POLE, &APPURTENANCES 5.00 ..WIRING - - TEMP LIGHT OR.,RECEPT. SYSTEM '. 3.00 FIXTURES POWER AUTHORIZED • _ UTILITY CO..•NOTIFIED - 3 FINAL- PERMIT FEE_ (SUB TOTAL)' NOTES: PLAN. CHECK FEE J P.ERMIT'ISSUING FEE 3.00 '3? g(j i TOTAL. FEE PLAN CHECK-VALIDATION CK. M.0.' CASH PERMIT VALIDATION CK. M.O. CASH 0 oy SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE tl r - � P/q L - f Ty APPLIC ` HON FOR ELECTRIC RIC PERMIT BUILDING �.- y / / icy ,mac✓40 ADDRESS LOCALITY FOR APPLICANT TO FILL IN. NEAREST MUMFEE CROSS ST I T E M 'NUMBER EACH I FEE OWNER OUTLETS: ` MAIL _ /�''+�' �Y�r ✓.�1 LIGHTS RECEPT. SW. .10 - ADDR`ESSSSt� ^ LIGHTING FIXTURES .10 CI rY/ ��9, /��� TEL. NO. ELEC.,RANGES, CLO. DRYERS ELECTRICIA 14WATER HEATERS .50 ADDRESS � ELEC.SPACE HTRS. DISHWASHERS " TEL..NO GARBAGE DISPOSERS AUTO.- STATE UTO.- ST WASHERS STA. COOKING UNITS' .25 U LICENSEENSE NO NO MOTORS: OVER INC. H.P. Via:^4; •..,,moi _S .^a x ... O— /z .25 — ® GROUP NE PR eYD BY 2 .50 INSPEMON RECORD l . :� T' 2 8 1:00 J ! I✓sbl-`.'.,.:.% ,f `'f.!Lj ; 5— 15 1.50 r �- 15— so , 2.50 - tr,' � �s'jjfrz•Y; 1F": ` 50-200- 5.00 NO. TRANS. SIGNS: NO. LAMPS SERVICE 0-60OV" ��� 6� 1.00 i - b�lr�.0 1'-""'•"�'� .�,f� , SERVICE OVER 600V 5.00 �! WIRING PERMIT ofooD� r f #` FIXTURE PERM,T 1.00 y SUPPLEMENTARY"PERMIT .50 -- 1. _'_� � ,,, VA TOTAL FEE $ APpROVAI kgV u I HEREBY ACKNOWLEDGE THAT. IHAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT- - ' WITH ALL CITI ORDINANCES AND�STATE LAWS REGULATING ELEC= TRICAL WIRING? - WIRING 1 HEREBY CERTIFY T I- A. PROPERLY ,REGISTERED AND_ /OR LICENSED- AS REQ RED BY HE CITY GF BALDWIN PARK AND FIXTURES' STATE OF CALIF NIA OR T AT 1 AM THE GAL OWNER OF THE - ABOVE DESCRIB D RESIOE 1 CFV POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMFINAL p� .. CK MO TCASN, V tea 9 4 1. 8%. AUG 2 7 2 D 4.5 0 ' WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 (� d�a LL APPn IC n TM* FOR ELECT AL PERNT ' I Hereby affirm chat I have a certificate 0 consent to self insure, or a certificate of worker's-Compensation insurance, or a certifies GOUN F'LOS ANGELES DEPT. QF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.73800 Lab.,C.) Policy No. Company - FOR APPLICANT-TO FILL IN JOB ) El _ ADDRESSl. Certified copy is hereby furnished. New Residential Bldgs.&P NO. EACH FEE LOCALITY 1 &2-Famil ,Sq.Ft. y ❑ Certified copy is filed with the county building inspection T _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR SS SSOR MAP PAR PAGE CEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. �iaM NAME i/ COMPENSATION INSURANCE V 1 �v � First 20 MAIL U (This section need not be completed if the work involved by the Total No. Additional ADDRESS J(t�1'I. permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY �4,7 Tel.No. q4VS 3,4 is issued, I shall not employ any person in any manner so as t0 PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you.should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances . APPLICANT t L-ro2 $NChRI -Ck u LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS C 1 41",_ I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of-Divisiop 3 of the Business and CITY rL,k ,1� Tel-No-yq3.-3p? Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. 7 } LICENSE OR Class. Over 50 to 100 Incl. REG.NUMBER d Over 100 DISTRICT NO. PkZTSSED BY O License Number Lic.Class FINAL �U 0 Ser 'ce S b MCC P el U Contractor `w�fir` e : 99 Am .Under 0 DATE �7 O ❑ 400-1000,Amp.Under 600 V t/ U I am exempt under Sec. �; VALIDATION ILLI Over 1000 Amp.or Over 600 V FINAL/ ii B.&P.C.for this reason BRANCH CIRCUIT FEES BY U) .15A,or 20A, 120V,Lighting or Recept. Z Date: 1 To 10 Branch Circuits_ Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for-Reg:Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances A+' '•T HOME OWNER-BUILDER DECLARATION •"l a T I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 7 iL for the following reason (Section 7031.5, Business and.Professions Additional Sign Branch Circuits KDJ- - _ Code): j 3 L ': I;as owner of the property, will do the work and the structure Misc.Conduits&Conductors 'i. - t, .-45 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ and Professions Code). ;a( '•._.• "1=''I CONSTRUCTION LENDING AGENCY !_•i?FPt=iL '€'d-I I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.)' D =y'=3 PLAN CHECKING FEE i ` ?r Lender's Name _ PERMIT ISSUING FEE p� �@ PM Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE �. that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize repres Ives of this County to enter upon the above-mentioned property fo spe io urposes. j�2�/ SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE Z ION WORKER'S I have a certificate of consent to 76A669DPW(12-91) Ui11�P16�@dA 0 � N FOR ELECT A PERNT 76A663 LL u�u 1 hereby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) Policy No. Company - FOR APPLICANT TO FILL IN - JOB ❑ ADDRESS , +'` Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY El $ $Ft S il Famy, q. . — Certified copy is filed with the county building inspection 1 &2- NEAREST department. Multi-family Sq.Ft. CROSS ST. i–, Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets:Rec._Light Sw. FIRM NAME First 20 MAIL (This section need not be completed if the work involved by the ADDRESS permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit CITY %~ ` Tel.No. is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws, Lighting Fixtures First 20 APPLICANT K Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP: NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. ' Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. PERMIT > provisions of the Labor Code, you must forthwith comply with such power Apparatus&Large Appliances APRLICANT '1/ = provisions or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS t I hereby affirm that I am licensed under provisions of Chapter 9' Over 3 to 10 Incl. a (commencing with Section 7000) of Division 3 of the,Business and CITY Tel.No. ,� f Professions Code,and my license is in full fo-rce and effect. Over 10 to 50 Incl ' Over 50 t0 100 Incl. LICENSE OR O REG.NUMBER Class. V Over 100 DISTRICT NO. PROCESSED BY W License Number Lic.Class J Services,Swbd.,MCC&Panelboards r LL Contractor ' Date 0 399 Amp.Under 600 V FATE >_ 400-1000 Amp.Under 600 V El I am exempt under Sec. VALIDATION Q Over 1000 Amp.or Over 600 V FINAL B.&P.C.for this reason BRANCH CIRCUIT FEES BY d Date: 15A,or 20A,•120V,Lighting or Recept. 1 To 10 Branch Circuits W Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits t,,Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION r" I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit (,• 1_.a for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): gib,. I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors `"II �ft'n; � P P Y, YCfe4•�f„ n is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). D ; CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) .4% CIV. C.) - ?lis,3�c"'`t:37 , PLAN CHECKING FEE i r Lender's Name •a� , PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property ' for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE 76A667-CE#817 10-62APPLICATIONr MBppNPER MIT COUNTY OF LOS ANGELES .� DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN.A. LAMBIE. COUNTY ENGINEER i ADDRESS 22 N. E1 Monte Ave. WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY Temple C i t FOR APPLICANT TO FILL IN, NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER Norman Short_ & Assoco WATER CLOSET $1.25 {� MAIL BATH TUB 1,25 ADDRESS 2341 First Street SHOWER 1.25 CITY. Santa Ana TEL. NO. 1} -21+35 LAVATORY 1.25cz Q .CONTRACTOR Parker Plumbinga SINK .1,25 ADDRESS 1+617 L' o Ramona Blvd. DISHWASHER 1.25 CITYBaldwin Park TEL. NO.EDe$1127 CONTRACTOR'S STATE STATE LAUNDRY 'CUB 1.25 REGISTRATION NO. 19771+7 COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PCE SED BY WATER HEATER 1.50 -3 1.50 INDUSTRIAL d GAS SYSTEM OUTLETS WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM ' .30 INSPECTION RE-CORPu a le,I n/ U A.J—r OLT Ir 4--l4- PA q p 4 � V1 z APPROVALS DATE INSPECTOR'S S GNATURE PERMIT $ L OO UNDER SLAB WORK _ `6 4-- tt ROUGH PLUMBING .fl+ A n. e1e.�a�I1. TOTAL FEE <. GAS PIPING w v� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF " GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIB D RES ENTIAL P TY. = UTILITY CO. NOTIFIED SIGNATURE - OF PERMITTEE Q /( FINAL ALIDATION ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R �I ilJo 8 3 1 7- IMAY 1 5 D 10.75- D.S'. 17 25M SETS 12-43 APPLICATION J[OR PERMIT DEPARTMENT OF BUILDING AND SAFE COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER PLUMBING NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE JPERMIT NO. (( } ROUGH FIXTURES COMPLETE V T v 33 HEATER CESSPOOL I`I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST/I�N�S®E{^C,T10N GAS- MISCELLANEOUS /V Y�Y ®® APPLICANT FILL IN HEAVILY OUTLINED [(PORTION � ONLY A !r NAME -1 f EIR17POOT,f o Mg A{ ,T�' ADDRESS /Ji A 7'-- liCi tri g ADDRESS 3558 East Co!ora o LOCALITY C.✓u ]Pasadena 8, Catlfornl ��, NEAREST ± IL 'I CITY TEL.No.�f'G-y(o/i CROBB ST. /c.tvi+s COUNTY CERT.NO. EXPIRES 6' NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL / NORTH O ADDRESS 1! CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. ZJ PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. a 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK _z BATH TUB FURNACE Q' SHOWER DISHWASHER E3 LAVATORY REFRIGERATOR KITCHEN BINK WATER SOFTENER FLOOR BINK BAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAB SODA FOUNTAIN OUTL GAS PIPING GAS VENT i I CESSPOOL I Iq TOTAL NUMBER OF FIXTURESSEPTIC TANK I LA CESSPOO SEPTICTANK G(, SEWER 8 UTILITY CO.NOTIFIED TOTAL FEE FINAL (� (�