HomeMy Public PortalAbout6130 HART AVE_Plumbing__ D.B.S.17 25M SETS 113-47 PERMIT APPLICATION
PP IC a ATI®N FOR S
DEPARTMENT OF BUILDING AND SAFE .";.•
COUNTY OF LOS ANGELES .
WM. J. FOX,CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP o E �P'^� MI O.
ROUGH FIXTURES �I COMPLETE r -J . % '
HEATER CESSPOOL I SEPTIC TANK RECEIVED BY READY FOR DATB ISSUED
FIRST INSPECTION
AS MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB �7
a, NAME ADDRES 0L _
m ADDRES /�A—, T p'/ LOCALITY
.J 2S�/7'I. NEAREST
D CI TEL.NO.&— CROSS ST.
COUNTY IL
CERT.No. EXPIRES W NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL
3 ADDR S '�
NORTH O
CITY ,6i1 TEL.No.
I AM THE LEGAL POSSESSOR OF THM ABOVE LOS
ANGELES COUNTY CERT IFI�QUALIFICATION.
.. (/ PLUMSEW
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
D ABOVE.
3 owdeR
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK-1-.11z
BATH TUB FURNACE
0!//
ROWERDISHWASHER LI
/ J
LAVATORY F; ' REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SANDTRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
—WATER CLOSET DRINKING FOUNTAIN DATE InsPe¢Tpe'a►1aMa
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I n I p
METERGAS SODA FOUNTAIN GAS PIPING i eI
OUTL
GAS VENT I I
CESSPOOL I
TOTAL NUMBER OF FIXTURES SEPTIC TANK i I
CESSPOOL SEPTIC TANK SEWER I
B co UTILITY CO.NOTIFIED I I,
TOTA=FEE y/-v �/u1
FINAL D 7 C
D.o.S.17 25M SETS 2-47 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFE
COUNTY OF LOS ANGELES
Wm- J. FOX. CHIEF ENGINEER PLUMBING
NATURE OF INSTALLATION DISTRICT No. GRo P ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE
HEATER CESSPOOL I ® I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
--- � /� FIRST INSPECTION
GAS- MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB
w NAME ADDRESS y,z
m ADDRESS LOCALITY( o
NEAREST 0 4
6 •CITY y 5;W � TEL.NO. CROS®ST.
COUNTY
CERT.No. EXPIRES NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL (S
3 ADDRESS
NORTH O
CITY TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
SIIIII ABOVE.
W
N OWNER
'1 CORRECTIONS
SOUTH
J
DESCRIPTION'OF WORK i
BATH TUB FURNACE
SHOWER DISHWASHER Q
LAVATORY REFRIGERATOR
KITCHEN SINK, WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS G2
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY I
ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING I I n
OUTL
.GAS VENT
CESSPOOL
� TOTAL NUMBER OF FIXTURES SEPTIC TANK
CESSPOOI' SEPTIC TANK / �'� SEWER
G� UTILITY CO.NOTIFIED i I
TOTAL FEE
FINAL
76A667-C E#817 10-67
'A-PPLiCATION FOR PLUMBNG PERMT '
L
GLLINT .•OF LOS ANGELES
• DEPATNlEN OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
c
JOHN A. LAMBIE. COUNTY ENGINEER ADDRES
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY "
o � 1
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST I
CROSS ST. C ret
NUMBER FIXTURE OR ITEM EACH FEE
OWNER -
WATER CLOSET 1.50 MAIL a e '
BATH TUB 1.50
ADDRESS �p 3 D Q P
SHOWER 1.50CITY -rn TEL. NO. y6 I9 7_3.-
LAVATORY 1.507/1CONTRACTOR C 1,C) jv Je. .,C Ccl
SINK 1.50 ADDRESS J 3 O Al
DISHWASHER 1.50 CITY TEL. NO. Y6I973 .
CLOTHES WASHER 1.50 STATE t LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 ' &
DISTRICT NO. GROU ZONE PROCESSED BY r
LAWN SPRINKLER SYSTEM 2.00 O
INDUSTRIAL C.1)
WATER HEATER 1.50
WASTE APPROVAL C)
' - O
GAS SYSTEM OUTLETS 1.50 -INSPECTION RECORD% ~
p U
OUTLETS OVER .30 g� d� � a
Lu
5 PER SYSTEM ' 2 At. kv y Cn
i
I 11711AI
Plan check fee.25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
z APPROVALS ATE INS TOR'S ATU RE
Plan check applicant UNDER SLAB WORKC9 G
Name ROUGH PLUMBING
Address o GAS PIPING
GAS VENT
City, Tel. No.
° HOT WATER HEATER
I HEREBYACKNOW LEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROP R Y. FINAL
SIGNATURE a JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDA'T'ION M.O. CASH_
PLAN CHECK VALIDATION CK. M.0. CASH
LJ*Lo4 7 4 4z: MAY20 5 D 9.50 m