HomeMy Public PortalAbout5003 GLICKMAN AVE_Plumbing__F 76A667 DBS 17 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING 2
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOPERMIT NO.
R APPLICANT TO FILL IN DI GROUP ZONE O�Py3 r
PLUMBER t� �'-' RECI$�{1/ED SY READY FOR D TE IS>IUED
rWC _✓ FIRST INSPECTION � �/
ADDRESS
BUILDING
CITY TEL No. ADDRESSCOUNTY
+-
Fniri e
LICENSE NO. EXPIRES LOCALITY �L-i ' •- _
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) @ 0.50 $ ADDRESS
BATH TUB @ 0.50 CITY TEL. No.
F�SHOWER @ 0.50 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTI^L PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 -f r
SIGNATURE OF
WATER HEATER @ 0.50 PERMITTE
SLOP SINK @ 0.5D INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50 ILI
URINAL @ 0.50 I-
_ f HOUSE SEWER @ 0.50 U_
MISCELLANEOUS J
a
o
APPROVALS
DATE INBPECTOR'B NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.Op F SEWER
PERMIT 1.00 GAS TEST
,.E� UTILITY CO.NOTIFIED
TOTAL FEE $
FINAL
D.B.S.-17 25AI SETS 12-45 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING
Wm. J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE _
NEATER CESSPOOL 1-1 SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
GAS MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
C NAME ADDRESS
a .r`. LOCALITY
ADDRESS
NEAREST
L CITY No. _ CROSS ST.
COUNTY e,
CERT.No. EXPIRES C NAME
W
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL
3 ADDRESS
NORTH O
CITY TEL. No.
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
A
• OWNER
CORRECTIONS
SOUTH
a
DESCRIPTION OF WORK Fyyy4
ATH TUB FURNACE
ROWER DISHWASHER �
LAVATORY REFRIGERATOR
_KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
GLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTORS NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING
OUTL �c
GAS VENT '✓
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
LL-
CESSPOO] gEPTIC TANK U SEWER
I $ UTILITY CO.NOTIFIED
TOTAL FEE
FINAL