HomeMy Public PortalAbout4921 FIESTA AVE_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer �/ U
DIVISION OF BUILDING & SAFETY G9
WILLIAM J FOX County Engineer
PERMIT NO
FOR APPLICANT TO FILL IN DIST 0 'w I— GROUP ON
((yy/ � lfJ
PLUMBERf^ A ":p RECEIVED BY FIRSTTIINSP�EyC�TION DY FOR �TE ;v/!�
ADDRESS 311 E $0t a ��°^�p y��/ r"
'I P413
CITY
hleis��}E1 ADDRESS
COUNTY LOCALITY
LICENSE NO c EXPIRES NEAREST y
PERMIT FEES CR059 ST ��P
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) 050 ADDRESS 1
BATH TUB 050 ::::::]—CITY a / TEL. No
SHOWER 050
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) O 50 APPLICATION AND STATE/THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 050 AND STATE LAWS REGULATING PLUMBING
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 050 ANGELES COUNTY LICEF SE OR I AM THE LEGAL OWNER
GAS SYSTEM__OUTLETS ® O 50 OF THE RESIDENTIAL PROPERTY DE CRIB D A VE
SIGNATURE OF , e✓YYtGZ•t��
WATER HEATER a O SO PERMITTED
SLOP SINK @ o so INSPECTION RECORD
FLOOR SINK 050
FLOOR DRAIN 050
DISHWASHER 050
DRINKING FOUNTAIN 050
URINAL 050
Q
HOUSE SEWER O SO Z
MISCELLANEOUS
Ai �J iia) / o
APPROVALS
DATE INSPECTOR S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL C@ 100 CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) P@ 1 00 SEWER
PERMIT 1 00 GAS TEST
TOTAL FEE UTILITY CO NOTIFIED
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FINAL S�
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APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISI
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS G T7
WATER CLOSET LOCALITY Z L
NEAREST
BATH TUB CROSS ST
SHOWER OWNER l
LAVATORY " MAIL
ADDRESS � � ��'T
SINK CITY TEL NO 4
DISHWASHER CONTRACTOR
U►.
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO S(eJ
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS - DISTRICT NO GROUP EOCESSE BY
OUTLETS OVER `� T
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL V
INSPECTION RECORD
&
Y2,Z- /V67- l
n V/
z
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
APPROVALS DATE INSPECTOR S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING r
City Tel No GAS PIPING 1n `
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER h[ 7
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES 1 1 14
REQUIRED BY LOS ANGELES C Y ND STATE O CALIFO IA ORT AT 1 AM TH GAS TEST
LEGAL OWNER OF AND INT TO S IN T ABOVE SCR( RESIDENT
PROPERTY UTILITY CO NOTIFIED I [
N r 7
SIGNATURE
OF PERMITTE FINALAZ
7�1',or �l�✓Ly
PLAN CHECK VALIDATIONcK M o CASH PERMIT GLIDATION K M o CASH
75 8�JUL 22 5 D 1 6/5 0 0-711' V Os