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7 XSW 17 '-00 APPLICATION FOR PEB.NIIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGEL S$ PLUMBING '
WILLIAM J. FOX, CHIEF ENGINEER
OR UCANT TO F IL IN
DISTR17NO. GROUP ZONE PETMrr NO.
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION S� 7
I �
ADDRESS
BUILDING Dom,
CITY T ADDRIMS
COUNTY ® LOCALITY
O
NEAREST
PESNIIT FEES CROSS ST
MUYRiR TYPE OF PIITURI OR ITiFEE OWNER
H
MAIL
WATER CLOSET TOI ) 0.50 ADDRESS - y�
LATH TUB IQ 0.150 CITY / TEL NO.
SHOWER 0.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LA A RY WASH BASIN) 0.00 APPLICATION AND BTATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN BINK 0.60 BTATI< LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 E ABOVE VALID LOS
LAUNDRY TUB OR TRAY O.DO ANGELES COUNTY LIC Q. R 1 AM THE LEGAL OWNER
OF THE REBIDQNTIAL P D ED 5OVK
GAS BYSTE3OUTLETS O.60
■IGNATURQ OF
WATER HEATER 0.60 FKRMITTE
SLOP SINK 0.SO INSPECTION RECORD
r
FLOOR SINK 0.00
FLOOR DRAIN 0.170
DISHWASHER 0.00
' DRINKING FOUNTAIN 0.00
URINAL 0 0.50 ,J
1
HOUOQ SEWS 0.50 z
MISCELLANEOUS O
a
0
APPROVALS
DATE IMlFECTOR'■ KAiii
ROUGH PLUMBING
G" PIPING
GAS VENT
CESS 1.00 CQSIPOOL
BEPTIC TANKI SEPTIC TANK
DRAIN ( ) PIT ( ) 0 1.00 SEWER
PERMIT . 1.00 GAB TmT
TOTAL FEE
UTILITY CO. NOTIFIED
FINAL
79AS7�t. APPLICATION F •'PLUMBING PERMIT
DIMON OF B=ING AND SAFETY
Dep-b-at of C -ty Engbmw
Cotinty of Los AnQalse BUILDING
�f
WM.J. FOX, COUNTY ENGINKXR ADDFtESB
CASSATY D.GRIFFIN, AUP•T OF]BUILDING
FOR APPLICANT TO FILL IN N BN Pt PEST T.
OWNER II V DIST'RrIQ GROU
MAILZ E ■[AL t Itsr[CTIDN
I _�7/�
ADDRQSS i
�I
r` INDUSTRIAL
CITY `r EL.NO. WASTE APPROVAL
PLUMBER VM )IV INSPECTION BECOBD
ADbRE88 :5 0 0.866 oN Ave
"TY' 4 TEL.No 333
LICENSK NO.
NUNa" TY"Or FIXTURI OR M M FLK
WATER CLOSET (TOILET) s O
MATH TUB O
SHOWER
LAVATORY (WASHBASIN) O
KITCHEN SINK
DISHWASHER '
LAUNDRY TUB OR TRAY
CLOTHES WASHER
t' TOTAL NO. OD
AMOVALS
DATE INS CT 'S SIGMA URE
GAS aver& ou ETB t.00 D
WATER HHATER 1.00 10
UNDE ORK
ROUGH PLUMBING
PERMIT �. �^ 00 GAB IPINd
TOTAL FEF GAS VENT
I HEREBY ACyOWLEDGE TgAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND ETAT'S LAWS REGULATING PLUMBING FIXTURZ9
PLUMBING.
I HFREBY CERTIFY THAT I Ail PROPERLY REGISTERED AMD/OR GAS TEST"
LICIrSED AS REQUIRED BY LOS ANGELES CO11�T1' AND STATE OP
CALIFORNIA OR THAT 1 AY. THE .LEGAL OWMER OE THE ABOVE '�ILITY CO.NOTIFIED
DESCRIBED RESID4NT PROPERTY. '
SIGNATURE
OF PERMITTE FINAL
WILLIAM J. FOX, COUNTY ENG1NUM VALIDATION R.A.WOOD.CNiR PLi0. 1NSPXCTOR
. r -
Ll� c31 0 9 1 w AN. 4 S 0 8 .0 0 �?