HomeMy Public PortalAbout5346 LOMA AVE_Plumbing__ 76AS67 OSS 17 11-50 APPLICATION FOR PERMIT
DEPA$TMENT OF BUILDING AND SAFETY
COUNTY OF L03 ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
NO. GR.OUP
ZONE PERMIT NO.
FOR APPLICANTTO FILL IN Z
PLUMBER �'H�MAS R. BRUMft RECEIVED B READY FOR DATE ISSUED
�VCC—� FIRST INSPECTION g_1171 �
ADDRESS Plumbing and Heating
Monte1912 Vista BUILDIN
CITY PASAdeneT L.N ADDRESS
COUNTY LOCALITY
LICENSE NO. I EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) @ 0.50 O ADDRESS
BATH TUB @ 0.50 d D CITY TEL No.
SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIB
LAVATORY (WASH BASIN) @ 0.50 60 APPLICATION AND STATE THAT THE ABOVE IB CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 rig AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VA1.JD LOB
LAUNDRY TUB OR TRAY @ 0.50 l749 ANGELES COUNTY LI NSE, OR I AM THE LEOALF OWNER
OAS SYSTEM OUTLETS Q 0.50 / �� OF THE RESIDENT PROPERTY SCR ED AB 'E.
.. SIGNATURE OF
WATER HEATER @ O.SO / QGJ PERMITTE
SLOP SINK @ O.SD S INSPECfION RECO
FLOOR SINK Q 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN 0.50
URINAL @ 0.50 J
Q
HOUSE SEWER @ O.SO _Z
MISCELLANEOUS L9
Q'
O
APPROVALS
D EINSPECTOR'S NAME
ROUGH PLUMBING r.y/� �� �O A-:
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMITI 1.00 GAB TEST
• UTILITY CO.NOTIFIED /J -�
TOTAL FEE � $ F
6 O �FINAL
APPLICATION FOR -PLUMBING
DBS-17 3-39 -
DIVISION OF BUILDING AND SAFETY
Department of County Engineer :J Q�
County of Los Angeles J V BUILDING `ul ate[
WM.J. FOX, COUNTY ENGINEER ADDRESS,
�nCASSATT D. GRIFFIN, SUPT OF BUILDING •• ,� ��'
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
_
41
OWNER `� c..p,. y DISTRICT NO GR UP I SONE READY FOR INSPECTION
MAIL u ! Same •� J A ' Now
_ADDRESS
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER GENERAL INSTALLATION CO. INSPECTION RECORD
ADDRESS 6358 West Blvd.
CITY ' L.A. 43 TEL NO Pleasant 3-2541
LICENSE NO 787 C-36 151839
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
1 WATER SOFTENER 1 00
-TOTAL NO @ o so APPROVALS
DATE INSPECTOR S SIGNATURE
GAS SYSTEM—' OUTLETS @ 1 00
UNDER SLAG WORK
WATER HEATER @ 1 00
ROUGH PLUMBING
PERMIT S, 1 00
_ GAS PIPING
TOTAL FEE 2 00 GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITH ALL COUNTY ORDINANCES AND STATE LAWS -REGULATING PLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED, AND/OR GAS TEST '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL-OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE G[LS '713HVP
OF PERMITTEE FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION R. A.WOOD, CHIEF PLBG. INSPECTOR
110
3 3 2FEB 27 3 .2.0 0