HomeMy Public PortalAbout5921 KAUFFMAN AVE_Plumbing__ DEPARTMENT OF COUNTY ENGrNEER K u lmo I
DIVISION OF BUILDING AND SAFETY PERM97 APPLOCATION
COUNTY OF LOS ANGELES
BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ,ADDRESS
FOR APPLICANT TO FILL I LOCALITY
' BUILDING { NEAREST
ADDRESS / GRDSS ST.
DISTRICT N0. GROUP ZONE PERMIT NO.
LOCALITY
NEAREST
CROSS ST. a.r z �✓ /�///RECEEIIVVEED BY Ready for Inspection DATE ISSUED p
OWNER r
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
INSPECTION RECORD
CITY TEL.NO.
PLUMBE
s
R x
ADDRESS / f F
CITY TEL. W"
6 C STATE
LICENSE NO. �_ COUNTY J
PERMIT FEES
z
4UM9ER TYPE OF FIXTURE OR ITEM FEE Vr
WATER CLOSET(TOILET) @ 0.80 $ j.
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY (WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM..............OUTLETS @ I.00 \
WATER HEATER @ 1.00 y
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
j,
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE 0 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED
AP1D/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN.
ER OF THE ABOVE DESCRIBED RESIDENTIAIy PROPE UTILITY CO.NOTIFIED
SIGNATURE /J��"�/�]`
OF PERMITTj.d .
- FINAL
76%6,7 D$S I7 < /
r.4 t. 11.5'i