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76A667 17 25M SETS 7-48 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN D R / GROUP Z P .
NOTTINGHAM
PLUMBER . COS
RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS 19-13 ~ �'1 Tve•
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CITY TEMPLE, � i 1F. JOB
ADDRESS .2
COUNTY
LICENSE NO EXPIRES
LOCALITY
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEARESTLI
ANGELES COUNTY LICENSE CROSS ST ,` C/
i!yy/'►�/i�/y�v�v OWNER r
MAIL
PUu BER ADDRESS
PERMIT FEE IS $1 00 FOR THE FIRST FIXTURE OR CITY TEL No
ITEM LISTED BELOW, PLUS 50c FOR EACH ADDITIONAL 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROP-
ITEM FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE
$1 00 MINIMUM FEE FOR ANY PERMIT $1 OO EACH
GAS SYSTEM IS A SEPARATE ITEM
OWNER
NUMBER TYPE OF FIXTURE OR ITEM
WATER CLOSET (TOILET) CORRECTIONS
BATH TUB
SHOWER � yp l9
LAVATORY (WASH BASIN)
KITCHEN SINK
LAUNDRY TUB OR TRAY
GAS SYSTEM OUTLETS '
WATER HEATER
SLOP BINK J ,
Q
FLOOR SINK Z
FLOOR DRAIN i 2
DISHWASHER x
0
DRINKING FOUNTAIN
URINAL
MISCELLANEOUS
I
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CEOSPOOL +_
SEPTIC TANK - DRAIN ( ) PIT ( ) $ SEPTIC TANK
1 CESSPOOL $ e SEWER
HOUSE SEWER $ 0 GAS TEST
1 Q
TOTAL FEE UTILITY CO NOTIFIED
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FINAL