HomeMy Public PortalAbout6355 GOLDEN WEST AVE_Plumbing__ ' CE ell(RtV.I l/,ZB)
APPLICATIONF R PLU PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
53-
NUMBER FlXTURE OR ITEM • FEE ADDRESS
WATER CLOSET LOCALITY
N EAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY
SINK CITYTEL - �7
DISH W ASH ER CONTR,qcr +
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CTTY TEL NO.
LAWN SPRINKLER SYSTEM STATE DG
WATER HEA7ER QA55
GAS SYSTEM OUTLETS APPROVALS DATE BLSPCCTORS SIQNATURE
OUTLETS OVER UNDER SLAB WORK
P�SYSTEM ROUGH PLUMBING
GAS PIPING
V
GAS VENT pt
HOT WATER HEATER 0
PLUMBING HXTURES
GAS TEST /
Plan check fee UTILITY CO.NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL �—
Plan check applkant PLAN CHECK VALIDATION
Name
Address
�09`9,,9A
CFty Tel.No. _
I HEREBY DGS THAT I HAVE READ THC1 APPUCATION AND STATR
THAT THL ABOVE CORRCCT AND
AG RE
C TO COMPLY WITH ALL GOU NTY ORDINANCES
AND STATE LAWS REGULATING PLUY0INQ PERMIT VALIDATION # o o'o o o 5
I HQiCBY CIRTaY THAT I AM PROPERLY REGISTERED AND/OII LICfiNSED AS
RCOUIRED BY IAS AWELES COUNTY AND STATE Of CALFORNIA OR THAT I AN THE L O,U 1a,O O
LEGAL OWNER W.AND INTEND TO RESIDE LN THE A1OVC DESCNIM RFSU)CNTIAL
rROPCRTY. o /o o 1' 0,0 0 cTS
H IOF Pfi RMfTTE + Q �+
2.7—8 0"
BY
INDUSTRIAL
WASTE APPROVAL
D.B.R.17 ZSM SETS 1-45 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING OF LOS ANGELES
Wm. J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. G upZON PERMIT NO.
ROUGH FIXTURES COMPLETE _
7 C'
RECEIVED BY READY FOR DATZ IUSS
I HEATER CESSPOOL SEPTIC TANK FIRST INSPECTION
GAS MISCELLANEOU8 �1
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
k2: NAME ADDRESS
W
D ADDRESS LOCALITY
I
D NEAREIIT
J CITY TEL.No. CROSS ST.
IL
COUNTY
CERT.No. EXPIRES C NAME
W
LOCATION OF SEPTIC TANK, OR CESSPOOL a MAIL
3 ADDRESS
NORTH O
CITY TEL.No.
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMURR
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
3 OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK a
z_
BATH TUB FURNACE _0
Q'
SHOWER DISHWASHER Q
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR BINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING
OUTL 1
GAS VENT ( 1
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK I I
CESSPOOL SEPTIC TANK SEWER
$ UTILITY CO.NOTIFIED
TOTAL FEE
FINAL V,~`