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HomeMy Public PortalAbout5243 HALIFAX RD_Plumbing__ 76Xee7 17 15-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN LTRICT-10. GROUP ZONE PERMIT NO. a � `I —(!a PLUMBER 4+ CEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS I©O �p AAII� 1 0 J, �/c BUILDING i wa u , CITY CVL-1� TEL. NA'D'i ADDRESS t� N [/,, COUNTY O v LOCALITY ei"44, LICENSE NO I EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM /f l 1 OWNER ' ,//QS7 Opp 1lS�yry � FE MAIL 2 / WATER CLOSET (TOILET) @ O 50 $ `� ADDR J (O � I BATHTUB Q O 501 CITY QX44GpG 01 /, TEL. NO.� SHOWER @ O 50 I 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 1 STATE LAWS REGULATING LUMBING. 1 CERTIFY THAT OSS ESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 501 Q ANGELES COUNTY OR 1 AM THE LEGAL OWNER OF THE REST DEN P TY DESCRIBED ABO �I GAS SYSTEM OUTLETS @ O 50r 1 T SIGNATURE O WATER HEATER @ O SOI D PERMIT 1 SLOP SINK @ 0 51- I INSPECTION RECORD 1 FLOOR SINK @ O 50 1 FLOOR DRAIN @ O 501 1 DISHWASHER @ O 501 1 DRINKING FOUNTAIN @ O 501 1 URINAL @ O 501 1 HOUSESEWER @ O 501 I Q Z MISCELLANEOUS U� I1 0 1 I I I� APPROVALS i 1 DATE INSPECTOR'S NAME ROUGH PLUMBING �I �/"'-/,v�✓ 1 GAS PIPING 1 GAS VENT CESSPOOL @ 1 00 I CESSPOOL 1 SEPTIC TANK: 1 SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.001 1 SEWER PERMIT . 1,00/ GAS TEST UTILITY CO NOTIFIED �` ✓ ,�� TOTAL FEE I $ vQ FINAL / 76A667 DBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENpINEER FOR APPLICANT TO FIDISTR NO. GROUP IN AY 'b A PLUMBER- pp�©`-B•f'' P RE EIVED BY READY FOR DATE ISSUED t/ FIRST INSPECTION ADDRESS --S,-V,3_? r BUILDI No tG S'Z J CITY Be� TEL No. (J'OGADDRESS3/� COUNTY / LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER , MAIL WATER CLOSET(TOILET) @ 0.50 111 ADDRESS BATH TUB @ 0.50 CITY TEL. No. SHOWER @ 0.50 1 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. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS @ 0.50 I / SIGNATURE OF WATER HEATER @ 0.50 PERMITTE��Z SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ O,So J HOUSE SEWER @ 0.50 SZl Z MISCELLANEOUS Q' 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 O V CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I 1.00 GAS TEST UTILITY CO. NOTIFIED �� jV TOTAL FEE q FINAL