HomeMy Public PortalAbout9967 LA ROSA DR_Plumbing__ I D.as.17 2s. APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
Wm. J. FOX. CHIEF ENGINEER '
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TURE OF INSTALLATION 'DISTRICT NO. GROUP ZO E Pp RMIT NO.
—I FIXTURES COMPLETE ' � /J 2
CESSPOOL I BEPTICTANK i' R�IVED� Y/ FIRSREADY
INSPECTION ? DA�188U�ED
RASM19CELLAfiE0U8 J SCJ
APPLICANT FILL IN HEAVILY OUTLIN�IED PrORTIpON ONLY
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JOB
MAIN' •�• ' ADDRESS 2 �J .� `i /�. �W ✓Q. 12,
ADDRESS N C-6OVERLY AVE ILOCALITY K140- rylh.,C)/iI-
TEMPLE CITYI�&, LIF. CCROSSSST. -.4 y NAME EXPIRES OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESSNORTH O
CITY TEL.No.
1 AM THE LEGAL POSSESSOR OP THE ABOVE LOBANGELES COUNTY CERTIFICATE OF QUALIFICATION.PLYNBEREGAL OWNER OF THE PROPERTY DESCRIBEDABOVE.
OWNER
CORRECTIONS
- SOUTH
J
DESCRIPTION OF WORK i
BATH TUB FURNACE 63
-------SHOWER —DISHWASHER D
LAVATORY REFRIGERATOR
KITCHEN BINK WATER SOFTENER
FLOOR BINK BANDTRAP
SLOP BINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN
DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I
METER GAS SODA FOUNTAIN
OUTL GAS PIPING I I
GAD VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK I I
U
_CESSPOOL-------SEPTIC TANK / SEWER I I
B UTILITY CO.NOTIFIED I I
TOTAL FEE
FINAL
76A667A CE 61]b{ -4/77 "-'"'O �
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE] BUILDING �+ / 0.
( O / (/r� O S
NUMBER FIXTURE OR ITEM ® FEE ADDRESS _
WATER CLOSET LOCALITY (' ®yl L C
NEAREST
BATHTUB CROSSST. 'D 1,(/ i V
SHOWER OWNER .. /`F C! L I C
MAIL
LAVATORY ADDRESS - -I-
0
� O
SINK CITY TEL.NO. 70'
DISHWASHER CONTRACTOR j �y
.r✓i o Na- � L' 'Gd
CLOTHES WASHER ADDRESS i Ac,
SWIMMING POOL RECEPTOR ✓�V� U� " G I
CITY TEL.NO. 2
LAWN SPRINKLER SYSTEM STATE LIC. 7
WATER HEATER LICENSE NO. .P CLASS �- G
IF GAS SYSTEM OUTLETS DISTRICT NO. I GROUP I ZONEPR SED BY
OUTLETS OVER 3 . (7U / I C
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
7/3) 121 Yom
Mz,
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL-FEE J
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CPLflNlq 0 IAM THE GAS TEST
LEGAL OWNER OF.AND INTEND TO RE51 IN THE DES EO SIOENTIPL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALID ON CK. M.o. usx PERMIT VA ID N �crcl M.o: - cnsx
II UL 27 s 1` 0b
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