HomeMy Public PortalAbout9228 LA ROSA DR_Plumbing__ 76AS67 DBS 17 11-SO APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY
�
--- OIINTY OFF LOS LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
DISTRICT NO. GROUP ZONE PERMIT NEI.
FOR APPLICANT TO FILL IN 1-7
PLUMBER �i RECEIVED BY READY FOR DATE ISSUED
ADDRESS C��� • FIRST INSPECTION
Q •`�.J�i Sof
CITY K TEL Na� 7 ADDRESS
COUNTY
LICENSE ND. �- EXPIRES �0 t,S`L LOCALITY
NEAREST
PERMIT FEES CROSS ST.
HUMBER TYPE OF FIXTURE OR ITEM FEE
OWNER
MAIL
WATER CLOSET(TOILET) 0.50 !$ ADDRESS d
BATH TUB 0.50 CITY - TEL 0. ,
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT•I 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 @ O.SO AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
GAS SYSTEMOUTLETS @ 13-51313-513OF THE RESIDENTIAL Of IAL PROP RTY DESr420—.LOC ABOVE.
C
SIGNATURE OF G
WATER HEATER @ 0.50 PERMITTEE
SLOP SINK 0.50 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN Q 0.50
DISHWASHER Q 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50
Q
HOUSE SEWER @ 0.50 Z
MISCELI'ANEOUS 5
0
APPROVALS
_ DATE INSPECTOR'S MAME
ROUGH PLUMBING
�
_,,s F
OAS PIPING I IlAA"Al-
GAS VENT :�- a/
CESSPOOL Q 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT . . I 1.OD ons TEST
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
V