HomeMy Public PortalAbout9234 KEY WEST ST_Plumbing__ 7GA667 DB917 it-SO APPLICATION FOR PERMIT.
DEPARTMENT OF BUILDING AND SAFETY �� ���� .
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
IS R T �O. GROUP
FOR APPLICAN(TTD FILL IN
PLUMBER `'' 1 I ��Ci ' ' I ZONE PERMIT NU.
READY FOR
RECEIVED BY FIRST INSPECTION DATEISSUED
ADORES3
CITY1:1�le TEL. N� ����� BUILDING .L/
ADDRESS 7
COUNTY p0� LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS BT.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER '
MAIL `�
WATER CLOSET(TOILET) @ 0.50 III ADDRESS/��/,�,
BATH TUB @ 0.50 CITY za-1--r TEL, Na.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE 'LEGAL OWNER
OF THE RESIDENTIAL P,OPE TY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50
SIGNATURE QF
WATER HEATER @ 0.50 PERMITTEE d
SLOP SINK @ O.So INSPECTION RECORD
FLQQR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 J
Q
HOUSE SEWER @ 0.50 Z
MISQELL.kNEOUS L7
Ix
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING .✓� )
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ) PIT ) @ 1.00 SEWER
PERMIT . . . I 1.qq GAS TEST
UTILITY CO.NOTIFIED ®'
TOTAL FEE
J FINAL u
76A667C (CE-81713) -9/75 '
APPLICATION FOR PLUMBING PERMIT
All
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) ADBUILDING a, Gf
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY "
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER Ci �z
LAVATORY MAIAD.DL
MAIL S K
SINK CITY TEL. NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL. NO.
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO. CLASS
DISTRICT NO. GROUPZONE CESS D B V
GAS SYSTEM OUTLETS ,� �
OUTLETS OVERG(Gj"
5 PER SYSTEM INDUSTRIAL w
WASTE APPROVAL N
INSPECTION RECORD
Plan check fee �� �ND�l2FL/2 /�Lt3G /N� WW ��FTff
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
Plan check applicant 6
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address e(/ ?"
ROUGH PLUMBING
City l Tel. No. GAS PIPING
I 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.
I 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 DPSESCRIB D RESIDENTIAL PROTY. UTILITY CO. NOTIFIED
SIGNATU RE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK: M,O. CASH
232'r-Try 19 5 U 3 4.5Q � .
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