HomeMy Public PortalAbout5600 GLICKMAN AVE_Plumbing__ 15EPARTMENT OF COUNTY ENGINEER PLUMBING 1
VIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
10 COUNTY OF LOS ANGELES
BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
NEAREST
BUILDING
ADDRESS CROSS ST.
DISTRICT NO. GROUP I ZONE PERMIT NO.
LOCALITY Q t)1 0,1
la
NEAREST
CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED
OWNER ()
MAIL ff INDUSTRIAL
ADDRESS f7 _ 1` ✓t= WASTE APPROVAL
INSPECTION RECORD
CITY TEL.NO. S '
PLUMBER —
ADDRESS
CITY TEL.NO.
0 STATE
LICENSE NO. []COUNTY .J
PERMIT FEES — a
_z
NUMBER TYPE OF FIXTURE OR ITEM FEE Ve
WATER CLOSET(TOILET) Q 0.80 U C
O
BATH TUB @ 0.80
SHOWER @ 0.80 bd
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80 G
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL I @ 0.80
GAS SYSTEM.-.6.--.--.-OUTLETS @ 1.00 90
WATER HEATER @ 1.00 D
ISC L ANEOU
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING /
GAS PIPING
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RES £NTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE �i
OFPERMITTEE----.........—......_._ .. ..L.-....-------
FINAL
76A667 DBS 17 1/53
76 A667C (CE-817B) -975
APPLICATION FOR PLUMBING PERMIT
I,
BUILDING SAFETY DIVIS2
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS S 0-0 6,III c-K N)?4,—'
WATER CLOSET LOCALITY -r-irmoc-e. a1'r
NEAREST
BATH TUB CROSS ST. I.) U t3-1 • A K
SHOWER 06 OWNER ' 0.
LAVATORY MAILADDRESS LI C-4---PA q Iti
SINK CITY (� Ln IZ TEL. NO.U4(C.S
DISHWASHER CONTRACTOR
1�►rCs��7 I i�F (�Ll�M 31 ems)�,
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR TEL >!L•
AR CA�1 P .
LAWN SPRINKLER SYSTEM CITY
STATE fL'N�� LIC _
WATER HEATER LICENSE NO.Z v_ CLASS �- 3 CD
O
DISTRICT NO. GROUP ZONE SCESSEQ BY V
GAS SYSTEM OUTLETSI CD
OUTLETS OVER �5 a �-3 � �
5 PER SYSTEM INDUSTRIAL _ w
WASTE APPROVAL �
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE �}
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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 REOU I RED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE / _
OF PERMITTEE - (rye ��SJJJ d� FINAL F- _ !Z�'I
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK.` M,0. CASH
6 9 44&F o 1 u.G U .
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