HomeMy Public PortalAbout5203 HALLOWELL AVE_Plumbing__ D.B.S.17 25M SETS 10-47 "' APPLICATION FOR PERART
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WM.J. FOX.CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT N • GROUP ZONE PERMIT NO.
ROUGH FIXTURESh COMPLETE -3(O
HEATER CESSPOOL SEPTIC TANK R CEIVED-BY READY FOR DATE ISSUED
FIRST INSPECTION _ /Q ��
AS MISCELLANEOUS �
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY�9 ) ��
K NAME J P. 11 PI !'iV!mr, ca ADDRESS r
g ADDRESS P.D.p.{�7v15/�7EASCT/�gBROADWAY LOCALITYNEAREST
6 CITY DBOX 6 SAN TE�I.o a:'y ' CROSS ST. /��'�d�.�I,
COUNTY K NAME
CERT.NO. 1014 EXPIRES W
LOCATION OF SEPTIC TANK, OR CESSPOOL 2 MAIL ` r
ADDRESS
NORTH O
CITY TEL.No
1 AM THE LEGA. POSSEOSOR-IOF THE-FABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUABMR
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNUR
CORRECTIONS
SOUTH .j
DESCRIPTION OF WORK
BATH TUB FURNACE
<Y
ROWER DISHWASHER 13
-LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
VWASH TRAY URINAL APPROVALS
VWATER CLOSET DRINKING FOUNTAIN
DATE INSPQCTOR'9 NAME
WATER HEAT R DENTAL LAVATORY ROUGH PLUMBING
�� 6TEFL_ GAS SODA FOUNTAIN GAS PIPING
OUTL
GAS VENT
�{ CE86POOL
TOIN
-TOTAL NUMBER OF FIXTURES U 6 SEPTIC TANK
CESSPOOI SEPTIC TANK SEER I I
3
TOTAL FEE �/ UTILITY CO.NOTIFIED
it FINAL �
76A667-CE#817 6-65
V ;• - Rr LJ
APPLICATION F R PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING �q
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS C/
COLEMAN W JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST '
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE '
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
CITY TEL. NO.
SHOWER 1.25
LAVATORY 1.25 .CONTRACTOR
SINE 1.25 ADDRESS oolr
DISHWASHER 1.25 CITYSTATE LIC
LAUNDRY TUB 1.25 LICENSE NO ,-2,gO,o' CLASS
CLOTHES WASHER 1.25 DISTRICT NO� OU ZONE P O E EP BY
WATER HEATER 1.50
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL O
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
lz
t u
W
CLZ
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 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.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED 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 '-�
FINAL
VALIDATION
CK M O CASH
L o 8 7 4 .4uc 2 5 D 6.5 0N