HomeMy Public PortalAbout8841 - 8841 1/2 ELM AVE_Plumbing__ D.S.S.17 25M S_TS 2-47 APPLICATION F®R PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
Wm.J. FOX. CHIEF ENGINEER PLUMBING
NATURE OF INSTALLATION DIS-TRIC-N-0. GROUP zOi E_�.P9ftMgsT NO-.
ROUGH FIXTURES COMPLETE — k! �f� ;7 /
HEATER CESSPOOL 1-1 SEPTIC TANK RECBIVED BY READY FOR FIRST ISSUED
FIRST INSPECTION ��
AS MISCELLANEOU ./' d�Z.",-
APPLICANT FILI. IN HEAVILY OUTLINED PORTION ONLYOB
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0:* NAMlIIV9. C. NOTTINGHAM C0 DDRESS ! 7ul
g ADDRESS OF TEMPLE CITY LOCALITYIZ3 N.
LY AVENEAREST
J CITY T�fLNP�€�ITTL,l�{o�I�� CROSS ST.
IL
�rl�t
COUNTY'
CERT.No. EXPIRES @d CC NAME ,PO
LOCATION OF-SEPTIC TANK, OR CESSPOOL , z MAIL
NORTH O ADDRESS
_ CITY TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE,OF QUALIFICATION.
.. ��i% C/� S'2'oL ���!_tt'`Ij 4:.•'E i-1�•.'.'i�-.f 1. I
PLUMBER
J AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
3 OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORD a
z
BATH TUB FURNACE 9
LY
SHOWER DISHWASHER Q
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY
ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING
OUTL ``
GAS VENT I l/
CESSPOOL "I '�/ / I
TOTAL NUMBER OF FIXTURES I
- SEPTIC TANK
CESSPOOL SEPTIC TANK i SEWER
$
( UTILITY CO.NOTIFIED I I
TOTAL FEE
FINAL
YDEPARTMENT.OF COUNTY,ENGINEER
DIVISION OF BUILDING AND SAFETY f����l�' AP.�t�l�A4!®!�
COUNTY OF LOS ANGELES pq BuiLDIrIG,
WILLIAM J. FOX, COUNTY ENGINEER �.ADDRESS -
FOR APPLICANT O FILL IN LOCALITY
BUILDING NEAREST `
ADDRESS CROSS ST.
DISTRICT N0. GRQP ZNE P RMIT N0.
LOCALITY
NEAREST --r—
CROSS RECEIVED Ready for Inspection D TE ISSU ,./
OWNEe9� a i 2 vj 7
MAIL INDUSTRI �-+
ADDRESS ��$ WASTE AP ROVAL C. S .
CITY i` TEL.NO.,
INSPECTION RECORD
P LU M a E RIAl, -
ADDRESS ...dd
CITY 4517 TEL.N
LICENSE N0. r 1�� 5 ` 0 COUNTY
_ - J
PERMIT FEES a
_z
NUM13ER TYPE DF FIXTURE OR,ITEM FEE
WATER CLOSET(TOILET) @ 0.80 S
BATHTUB= _ @ 0.80 �.' � `. J! (<v/I.�/sFT (_�✓fC,� O
SHOWER @ 0.80 11ri4A1'7-
LAVATORY(WASH BASIN) @ 0.80 A�-Al2-/ rl J9PPd Al 5-121?
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOORSINK @ 0.80
i
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM_...........OUTLETS @ 1.00
WATER HEATER @ 1.00
MISCELLANEOUS
y APPROVALS
r
1P, A �♦ DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 • ROUGH PLUMBING Z C1 '1r )q
TOTAL FEE f` GAS PIPING
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED' _
.AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDEN IAL PROPERTY.. UTILITY CO.NOTIFIED
SIGNATURE g%) q
OF PERMITTE ... ..-_-_-. �_..- _._..�- ---.._ .. ._.._ t� f�
FINAL
76A667 DBS 17 1/53 1