HomeMy Public PortalAbout5623 GRACEWOOD AVE_Plumbing__ 76AS67 DBS 17 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1
: PERMIT NU.
FOR APPLICANT TO FILL IN 1 T w N RO P r /
PLUMBER L.E- REEEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
_ADDRESS ."? y
BUILDING
CITY TEL No. ADDRESS , /►
COUNTY LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS BT.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL l'
WATER CLOSET(TOILET) 0.50 S C ADDRESS
BATH TUB @ 13.5DQ CITY ; /' / '
TEL No.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0 0.50 APPLICATION AND STATE AH
E ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALLCO.UNTY ORDINANCES
KITCHEN SINK @ 0.50 r- AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 C ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
_ OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM---'?—OUTLETS @ 0.50
SIGNATURE OF
WATER HEATER @ 0.50 PERMITTE
SLOP SINK Q 0.50 INSPECTION RECORD
FLOOR SINK Q 0.50 t,
FLOOR DRAIN 0.50 A +
DISHWASHER C.SO 1 1 R Irp (F TS
DRINKING FOUNTAIN 0.50 1000-j
URINAL 0.50 R T� r t., 8 - a
J� HOUSE SEWER 0.50 Z
MISCELLANEOUSt 9
�•,) �, Q'
2 �---� O
' r res r
c9 FF
APPROVALS
DATE INSPECTOR-8 NAME
r I ROUGH PLUMBING
OAS PIPING
GAS VENT
CESSPOOL @ 1:00
CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT1.0o GAS TEST /
• UTILITY CO.NOTIFIED - (•'
TOTAL FEE
$
r C,
FINAL