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Home My Public Portal About10786 LIVE OAK AVE_Plumbing__ 78A687 •CEA817 5/63 ,.. APPLICATION FOR 'PLUMEING PER'MI'T" COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 10786 E. Live Oak WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY Temple Cit FOR APPLICANT TO FILL IN CRO 3 ST. C� NUMBER FIXTURE OR ITEM EACH FEE y ! WATER CLOSET 51,25 OWNER Evergreen Sanitarium MAIL BATH TUB 1.25 ADDRESS S8Lme SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR Belvedere Plumb in .,C O o SINK 1.25 ADDRESS 13350 Ecter DISHWASHER 1.25 CITY- City of n Li tr NO GI 89836 1 LAUNDRY TUB 1.25 1 251'REGISTRAT ON NO. 179568 COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NOGROUP ZONE P OCESSED BY WATER HEATER 1.50 -� 1.50 INDUSTRIAL r r GAS SYSTEM OUTLETS WASTE APPROVAL I 0 OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD V 0 F a N Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK 5 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT I WITH AL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER �,• //'L- IA I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES I ` �rvv LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST I ' CALIFORNIA OR THAT 1 nLRZE.) LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DRESIDENTIALPROPERTY UTILITY CO NOTIFIED ------------ SIGNATUREOF PERMITTE FINAL LIDATION ROBERT A WOOD CK M O CASH SUPERVISING MECHANICALENG'R �r�t,o 5 8 0 0- FEB 21 5 D 5.75- 76A667 -CE}f817 2-62 / APPLICA IOM FOR PLUMBING P FaMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 10786 Eo Live Oak WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY Temple FOR APPLICANT TO FILL IN1. NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER . -Evergreen Sanitarium WATER CLOSET E1.25 MAIL BATH TUB 1.25 ADDRESS 10786 E. Live Oak SHOWER 1.25 CITYTe lE City TEL. NO. LAVATORY 1.25 CONTRACTOR Belvedere Plumbing Co. SINK 1.25 ADDRESS 13350 Ector DISHWASHER 1.25 CITY City of Industry TEL. No. GI 89836 1 ATE LAUNDRY TUB 1.25 REGISTRATION ON NO. 179568 COUNTY ❑ CLOTHES WASHER 1.25 k DISTRICT NO GROUPXZNE P SSED BY WATER HEATER 1.50 t 2 GAS SYSTEM 2 OUTLETS 1.50 3 00 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 30 _ IrfSPECTION RECORD— / 0 o r APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK M ROUGH PLUMBING , TOTAL FEE 5, 00 GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT CORRECT AND AGREE TO COMPLY AND STATE THAT THE ABOVE IS WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING F XT RES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ! CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.AND INTEND TO yab RESIDE IN,T BOVE DE Cl" D RESIDENTIAL PROPERTY UTILITY CO N6TIFIED I _ 1 Q SIGNATUR OF PERMI EE "`�� 111 _ FINAL ATION ROBERT A CK M J CASH SUPERVISIN MECHANICAL ENG R _.w_LrvC0 6,2 6 1-0 MAR 5 D 5.00- w D.S.S.-19 25M SETS 1146 1 APPLICATION FOR PERMIT OF BUILDING AND SAFE ,1 COUNTY OF LOS ANGELES PLUMBING ' WM.J. FOX.CHIEF ENGINEER -NATURE OF INSTALLATION i DISTRICTNO. GROUP ZONE PERMIT NO.. ROUGH FIXTURES COMPLETE � I HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION AS MISCELLANEOUS APPLICANT FILL IN HEAVILY- OUTLINED PORTION ONLY NAME JOB o IK ADDRfiBS m ADDRESS / LOCALITY \ J IL CITY .NO. COUNTY CERT.No. EXPIRES NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL _ ADDRESS NORTH O CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE- LOS. ' ANGELES COUNTY CERTIFID/IC9E OF QU A�� PLUMBER { 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. p 3• OWNER CORRECTIONS SOUTH J o DESCRIPTION OF WORK _Z BATH TUB FURNACE C] IY SHOWER DISHWASHER O LAVATORY REFRIGERATOR _—KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER—GAS _—GODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES , SEPTIC TANK I ll CESSPOOI._—SEPTIC TANK / SEWER - S UTILITY CO.NOTIFIED I ` TOTAL FEE 111 � FINAL 76A667 -CE#817 2-62 I Y�/ .,j4 PL.ICATIOf`I FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER - BUILDING AND SAFETY DIVISION BUILDING --!� JOHN A. LAMBIE. COUNTY ENGINEER ADDRESSOak WILLIAM A INSEN�SuP•T OF BUILDING LOCALITY, , m le ty ,FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER ,FIXTURE OR ITEM EACH FEE OWNER Ever reen Sanitarium ' 17 WATE CLOSETetpfl p y $1.25 21 25 MAIL 4,L'BATH�TI B f 1.25 5 00 ADDRESS Same x �/�SHOWER" 6 1.25 2 5o%ovlCITY TEL. NO. 20 LAVATORY (� �j 1.25 2 oo CONTRACTOR �elvedere 'Plumbing Co. SINS I 2 f, 1.25 .6 �5 ADDRESS 11900--E. 1 DISHWASHER 1.25 1 25 CI1•Y El Monte TEL. NO. 89836 CONTRACTOR'Spp STATE 2, VLAUNDRY TUB �'� 1.25 2 50 REGISTRATION NO. 179568 COUNTY 0 CLOTHES WASHER 1.25 -DISTRICT NO GROUP ZONE ^PR ESSED BY ft WATER HEATER p 1.50 0 GAS SYSTEM S OUTLETS 1.50 ] 50 INDUSTRIAL WASTE APPROVAL � ) OUTLETS OVER 5 PER SYSTEM 30 — INSPECTION CORD / d �� 0 1 Shampoo bowl 3 3 1 25 °` 3'` 1 6 61 Ul 1, �t�n��cl f��5r� O nki fountain 1 1 25 ,- ' rI19 3 becipan cleanser6 jar 15 00 - - 1`�,/ �I..�.v r��c�-•.. ,�� . � 1 APPROVA S DAITE, INSrP.E�E PERMIT $ 2 00 UNDER SLAB VAORK ,ROUGH PLUMBI G TOTAL FEE 91 40 GAS PIPING / r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT�WATER-HEM PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR F?LtPMBING FIXTUREjfljV le LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DES D RESIDENTIAL PROPERTY UKILIWCO NOTIF D SIGNATURE f// OF PERMITT FINAL V IA LIDATION ROBERT S'WOOE J cK M J 1 CASH SUPERVISING MECHANICAL ENG R l ,a 1 9 8 3 0CT "9 5 D 9 1.4 0 rr i D s.S-17 25M SETS 12-45 APPLICATION FOR PERMIT DEPARTMENT OF, BUILDING AND SAFETY �� COUNTVIbF LOS ANGELES Wm. J.aFOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE HEATER _ CESSPOOL 1-47-1 SEPTIC TANK ETfg l ED Y READY FOR DATE ISSUED ._ / �/d•i/-' 1 FIRST INSPECTION ry �- 6A8 MISCELLANEOUS !V/(/ V// ..�� .J,7J l7L_ APPLICANT FILL IN HEAVILY OUTLINEG�D PORTION ONLY , JOB S NAME I(0c � t �'��n.a ADDRESS �'S B / ' ,.•�� in ADDRESS 2, _40 /{ .��-(,rr� LOCALITY NEAREST IL CITY tQ et,,,��m TEL.No. CROSS ST. I COUNTY CERT No EXPIRES X NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL No I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICA;rX OF QUA;IFICATION. PLUMBER _ I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBHD p ABOVE. 3 OWNER CORRECTIONS SOUTH a DESCRIPTION OF'WORK BATH TUB FURNACE (� a HOWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER , FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE, INSPECTOR'S HANG WATER HEATER DENTAL LAVATORY ROUGH PLUMBING DETER GAS QODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI- SEPTIC TANK SEWER S UTILITY CO.NOTIFIED TOTAL FEE FINAL D.B.S.17 25M SETS 12.44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY, COUNTY,,OF"LOS ANGELES PLUMBING WM. J.FFdX-;,CHIEF ENGINEER NATURE OF INSTALLATION DISTRIPT NO. G//R.�O�UP ZONE PERMIT NO. ROUGH FIXTURES1_1 COMPLETE /✓• I (�s ll� HEATER CESSPOOL SEPTIC TANK RE EIVED BY READY FOR DATE ISSUED GAS MISCELLANEOU8 memm Q�� 0` FIRST INSPECTION e APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY �f' JOB § / V ' 0 4et'�e►^ 42AA-C , . C NAME a ♦ ADDRE8 W per_ �I a III ADDRESS a `� f � •LOCALITY „K, O 1 /f?p- 7 �j(a CROSS I�rdt,(�► OLK�� , '1 CITY "Qi TEL.No. / f�V CR063 ST. IL COUNTY A / CERT.No. /CJ421 EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL. Z MAIL � 1=9` /� �*� ADDRESS __ f�,.�,., NORTH O CITY -� a.�, `TEL.No. •,' I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLIUMBER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. rn i OWNER q CORRECTIONS ' ��,.y,r'm..'�� /larz�+xi'��r,..!.+€,+�`�.o.ar,�,>.t'.i� •�„z,..ts.«_�fa+,a,- r ti SOUTH �i DESCRIPTION OF WORK .BATH TUB FURNACE a ._SHOWER DISHWASHER LAVATORY REFRIGERATOR _KITCHEN SINK WATER SOFTENER FLOOR BINK SAND TRAP SLOP SINK FLOOR DRAIN �v WASH TRAY URINAL APPROVALS' t _WATER CLOSET DRINKING FOUNTAIN ! DATE 'INSPECTOR'S NAME WATER H EATER DENTAL LAVATORY ROUGH PLUMBING METER-LI-GAS AS +aODA FOUNTAINaq9 PIPING T : OUTL ~ GAS VENT `/I CESSPOOL 4,e e `/�/A 1•�.Z 5 v'y TOTAL NUMBER OF FIXTURES �� SEPTIC TANK CESSPOOI SEPTIC TANK SEWER I I dpi TOTAL FEE 010 `D $. o D UTILITY CO.NOTIFIED FINAL D.B.S.17 2SM BETS 1-40 - APPLICATION FOR PERAUT DEPARTMENT OF BUILDING AND SAFETY PLUMBING � ' � ' COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT GROUP ZONE PERMIT o. ROUGH FIXTURES COMPLETE ! —��4 " HEATER CESSPOOL ( SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION q MISCELLANEOUS APPddPLIICANT JFILL IN HEAVILY OUTLINED PORTION ONLYlzj / NAME Ld. f c7 N� ��C@tet ADDRESS 7t W ADDRESS AA LOCALITY t. n1 NEAREST NN,CITY ��a TEL.No. CROSS ST.COUNTY CERT.No. _ EXPIRES I NAMEld LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRESS 1 NORTH O CITY TEL.NO. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER �— I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. a W OWNER i CORRECTIONS SOUTH J DESCRIPTION OF WORK Z BATH TUB FURNACE O lr SHOWER DISHWASHER Q AVATORY REFRIGERATOR KITCHEN BINK WATER SOFTENER _FLOOR BINK SAND TRAP SLOP BINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I METER—GAS --SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I r d CES SPOO�SSEPTIC TANK SEWER IR S UTILITY CO.NOTIFIED TOTAL FEE FINA 76A667-CE817-8-58 �� APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS CASSATT D. GRIFFIN,Supt of Building LOCALITY l -�: FOR APPLICANT TO FILL IN NEAREST y 'Cy' I CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET BATH TUB AD RESS CITY TEL. NO.,Ll, _S 9^ SHOWER CONTRACTOR " LAVATORY , SINS ADDRESS DISHWASHER CITY TEL. NO. CONTRACTOR'S STATE 0 LAUNDRY TUB REGISTRATION NO. - � COUNTY ❑ CLOTHES WASHER DISTRIW NO./_ GROUP P OCESSED BY WATER HEATER :�� GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS Ccb $1.00 PER ITEM OR FIXTURE $ v J DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COU N Y AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OW R OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPARTY. SIGNATURE // J OF PERMITTE(i FINAL ROBERT A.WOOD. Or VALIDATION SUPERVISING MECHANICAL ENG'R CK. H.O. CASH i 76A667ACE 817 1812 8L o 4': S r: v1- .. . COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS NUMBER FIXTURE OR ITEM @ FEE LOCALITY 40 WATER CLOSET NEAREST V ! / BATH TUB CROSS ST ` C� " ow SHOWER O {UWNER C _ LAVATORY MAIL /ADDRESS (l—l� SINK CITY �/ TEL N04t( DISHWASHER y� CONTRACTOR `�� 1,4- � ��A/ F62 CLOTHES'WASHER C9 ADDRESS SWIMMING POOL RECEPTOR CITY ' TEL N LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER ICENSE NO CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR 5 SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING J � V/ GAS PIPING GAS VENT HOT WATER HEATER •► PLUMBING FIXTURES GAS TEST Plan&eck fee UTILITYCO NOTIFIED PLUMBING PERMIT ISSUING FEE$ �� _ TOTAL FEE / FINAL Plan check applicant PLAN CHECK VA IDArION Name Address City Tel No gyp a 9 7 A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE '�"��►�j 5 • ..�IQ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES # O O O O O AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION , IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR-LICENSED AS 2 O O 1 O e REOU IR ED BY LOSANG E COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INT ND TO RESIDE IN HE ABOVE D CRIBED RESIDENTIAL - PROPERTY O O u „I((�G SIGNATURE 0 G 2'�C: 0 OF PERMITTEE DISIRLCTND_ `�' CESSED a oY 1 INDUSTRIAL WASTE APPROVAL �76A667A CE,81 2:Rf-V,6/48) F I Os,i� • APPLICATION FOR PLUMBING PERM IT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING •� ADDRESS NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST SHOWER OWNER �V'�ger&w LAVATORY MAIL'' (jam ✓� w�r ADDRESS (Q SINK CITY TEL No�47 i DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS L� (/ C SWIMMING POOL RECEPTOR ` CITY TEL N / LAWN SPRINKLER SYSTEM STATE 1-3 � LIC WATER HEATER LICENSE N p�e.l CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR 5 SIGNATURE UNDER SLAB WORK ( go G4r./ OUTLETS OVER S { 5 PER SYSTEM ` ROUGH PLUMBING -' GAS PIPING _ GAS VENT HOT WATER HEATER 0(� PLUMBING FIXTURES NJ GAS TEST Plan check fee UTILITYCO NOTIFIED «55 PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL Plan check applicant PLAN CHECK VALIDATION NameC Address City Tel No .728934A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE # O O O O o5 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION 2 D - 1 Q 0 C I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS O O O 1 O C.: REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INT NO TO RESIDE IN THE ABOVE DE CRIBED RESIDENTIAL PROPERTY SIGNATURE OFPERMITTEE DISTRICT NO OCESSED BY V /Q INDUSTRIAL WASTE APPROV 1 yeaea, +� reo APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT GROUP ZONE PERMIT NO. os-7s8 A.C. Nottingham Co. of Temple City RECEIVED BY READY FOR DATE ISSUED PLUMBER LOVERLY AVE, �. FIRST INSPECTION �Q S [ADDRESS '(FMI?LF CITY,onALIr. BUILDING �y CITY TEL NO. ADDRESS L/ COUNTY LOCALITY LICENSE NO EXPIRES NEAREST PERMIT FEES CROSS ST. . O�I�}/� /�✓a �+�- ( �� NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ O SO $ ADDRESS BATH TUB @ O 50 I CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY LICENSE, OR I„AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS @ O 501 SIGNATURE OF � R @ O $OI I P MITTEI w � r WATER HEATE SLOP SINK @ o Sol 7 77 INSPECTION RECORD FLOOR SINK @ O SOI I FLOOR DRAIN @ O 50 DISHWASHER @ O 501 �Z _✓ / DRINKING FOUNTAIN @ O 501 1 URINAL @ O Sol HOUSESEWER @ O 501 I Q Z MISCELLANEOUS O I� I� Imo_ APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1 OOI CESSPOOL SEPTIC TANK: 1 SEPTIC TANK I DRAIN ( ) PIT ( ) @ 1 00 SEWER PERMIT . I 1.00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE $ 6 D �►-_ FINAL r 'I