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B. 17 4 s zsM 1' � 'AP'PLICATION FOR, PERMIT
v•DEI'AItTMENT OF,,BU•ILDING:AND SAFETY T
COUNTY OF .LOS ANGELES PLUMBING
WM. J. FOX, CHIEF ENGINEER
• NATURE OF INSTALLATION
DISTRICT NO. GROUP, ZONE PERMIT No.'
ROUGH I �• �l� — i t l�d ,
PLUMBING FIXTURES I I COMPLETE I READY FOR RECEIVED 'BY DATE ISSUED
HEATER CESSPOOL (SEPTIC TANK FIRST INSPECTION
GAS MISCELLANEOUS,
PLICANT FILL IN'H VILY OUTLINED PORTION ONLY
AD RtE
NAM ADDRESS
m ADDRESS LOCALITY
f
NEAREST•-i -
IL
CITY TEL o.,, '"Y �'�' CROSS ST. ;t•
_ REG. NO. EXPIRES W NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL't • 3: "`AIL"5 rt ''
NORTH - O :,:.
.. CITY. No.
� '. CORREC• S .
LL
SOUTH
DESCRIPTION OF WORK
BATH TusFURNACE•
' 'SHOWER DISHWASHER APPROVALS •"
LAVATORY REFRIGERATOR' s �DATE INSPECTORS NAME
• " KITCHEN
IS WATER SOFTENER ROUGH PLUMBING LS• f Q
FLOOR SINK ; SAND TRAP GAS PIPING
I 1
SLOP SINK FLOOR DRAIN GAS VENT I '
• WASH TRAY, URINAL CESSPOOL
WATER CLOSET DRINKING FOUNTAIN SEPTIC TANK /
WATERHE ER DENTAL LAVATORY SEWER
M ETERGAS SODA FOUNTAIN UTILITY CO. NOTIFIED
r OUTL
"• " FINAL
• 1 AM THE LEGAL OWNR OF ZHE ABOVE L S ANGELES
COUNTY REGISTRATION 11
TOTAL NUMBER OF FIXTURES 0010
EPTIC TANK '� - PLu sER j
CESSPOOL - I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
I ABOVE.
' "TOTAL FEE: �f' . / •
OWNER •-�' t