HomeMy Public PortalAbout5922 ENCINITA AVE_Plumbing__ D.B.S.-17 25M SrTS 12-45 f
APPLICATdON FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ������M 53�
Wm. J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES _I COMPLETE 1:5, ` / �/ //G '/
HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
/l r FIRST INSPECTION
GAS M16CELLANEOU8 OL •�• �J
APPLICANTT FIL/JL IN /HEAVILY OUTLINED
/PORTION ONLY
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1E ADDRESS 7 /: �, A� �/ /C S� /I/` LOCALITY ,liia�i�,f- L7•G�/:
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NEAREST y/ I may+ tr
y CITY r� i v� C Y TEL.Nod' f/ CROSS ST.
COUNTY
CERT.No. `� ? � EXPIRES,�' s , "�j% p NAME y/
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LOCATION OF SEPTIC TANK, OR CESSPOOL 2 MAIL
ADDREB9
NORTH 0
CITY TEL NO.
IAM THE LEGAL POSSESSOR OF THE ABOVE LOB
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER y�T
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
A ABOVE.
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a =CORRECTIONS
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DESCRIPTION OF WORK
BATH TUB FURNACE - a.
-------SHOWER DISHWASHER O
LAVATORY REFRIGERATOR
KITCHEN BINK WATER SOFTEN ER
FLOOR BINK SANDTRAP
SLOP BINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE IIN�SPECTOR'$NAME
__L__WATER HEATER DENTAL LAVATORY - ROUGH PLUMBING I ri,'�• I ,r •;f�%
METER T GAB -ODA FOUNTAIN
OUTL GAS PIPING '{
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
CESSPOOI SEPTIC TANK SEWER
S
TOTAL FEE U D UTILITY CO.NOTIFIED
FINAL
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7BAS67-CE017 12159 '
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SF nTY DIVISION rAD"LDING 5922 N. Encinita Ave.
JOHN A. LAMBIE, ouNTY ENGINEER HESS
WILLIAM A. JEN6EN, 6upTop BUILDING CALTI'Y Temple City, Calif.
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER A. S. Tomich
wATEacyosETMAIL
ADDRESS ()5 22 N. Encinita Ave.
BATH CrnTemple City TEL No. AT-6-3846
SHOWER
LxvxroRY CONTRACTOR Duce Plumbing & Heating
SINK ADDRESS 3232 N. San Gabriel Blvd.
DISHWASHER cITYSO.S'an GabrielEL• NO. AT-0-4931
CONTRACTOR'S p STATE ❑
8
LAUNDRY TUB REGISTRATION NO. 104 COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP I ZONE ROCESSED BY
WATER HEATER � ..l
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD a.
0
O
U
C
O '
W
0.
N
z
0 51.00 PER ITEM
OR FD=RE S APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2100 UNDER SLAB WORK
TOTAL FEE ' ROUGH PLUMBING
11,71 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 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 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 0 �R OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE I
OF PERMITTE FINAL
®.
c[.OVALMAnON ROBERT A. WOOD.
M.0. CASH SUPERVISING MECHANICAL ENG'R
LACp 9 3 1 3 " APIs 14 5 A 3.0 U r
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