HomeMy Public PortalAbout6261 HART AVE_Plumbing__ 77
7;eAe67 17 3-50 12) APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER PLUMMNO
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO..
PLUMBER Revere Service Corp.. RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
[ADDRESS 11811 jeald_= St.. NOW
�7 BUILDING / Hart A/4
CITY Culver City TEL. NO. EX !21.51 ADDRESS 6LL7=No• rt Ave.
COUNTY6.750�M 6- 0 51 LOCALITY Temple City
LICENSE NO. EXPIRES 3 J J
CROSS S Garibalai Ave o
PERMIT FEES TT�� /7Ch1,, u�
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER X.'. il Y+er
WATER CLOSET (TOILET) @ 0.50 $ MAILADDRESS Same as above
iBATH TUB @ 0.50 1 CITY TEL. NO.
SHOWER @ 0.50 1 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
1 LAVATORY (WASH BASIN) @ 0.50 I APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 1 -STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE V.lPD LOS
1 LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OF}/I AM THE ' GAL OWNER
OF THE RESIDENT I PROPERTY DESCRIBED B VE:
1 GAS SYSTEM OUTLETS @ 0.50 1
SIGNATURE O
WATER HEATER @ 0.50 I PER MITTE
SLOP SINK @ 0.50 1 INSPECTION RECORDt�'�i
F-= FLOOR SINK -- @ 0.501 1
, FLOOR DRAIN @ 0.50 1
DISHWASHER @ 0.501
1 DRINKING FOUNTAIN- @ 0-50, 1
1 URINAL @ 0.50.1 .J
IHOUSESEWER @ 0.501 Q
1 _ z
MISCELLANEOUS (�
b Rater 9&tener 50 �
1� o
APPROVALS
1 DATE INSPECTOR'S NAME
1 ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL@ 1.00 1 CESSPOOL
1 SEPTIC TANK: SEPTIC TANK
i DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT . . 1.00 GAS TEST
I UTILITY CO. NOTIFIED
TOTAL FEE $
1 I g O FINAL