HomeMy Public PortalAbout5631 LOMA AVE_Plumbing__ 7SA667 DBS 17 11-s0 APPLICATION FOR PERMIT
DEPARTMENT OFBUILDING AND SAFETY
COUNTY OF-LESS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN TR y O. O Z'I _�PERMIT O./
S YJ•
PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEI)(ED BY READY FOR DATE ISSUED .
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FIRST INSPECTION � ������
ADDRESS 8300 EAST VALLEY /J
A BUILDING
CITY ROSEMEAD TEL. No. AT. Z'Z719 ?'DDREBSCOUNTY
LICENSE NO. 93M EXPIRES 6-30' LOCALITY
NEAREST
PERMIT FEES CROSS BT.
NUMBER TYPE OF FIXTURE OR ITEM FEE DWNER r
MAIL
f WATER CLOSET(TOILET) @ 0.50 $ ADDRESS
f BATH TUB @ 0.50 1CITY TEL No.
SHOWER @' 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE-READ THIB
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.
I1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50AN' ELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
- / OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE/
GAS 5YSTEM OUTLETS @ 0.50
SIGNATURE OF
WATER HEATER @ 0.50 PERM ITTE
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR BINK @ 0.50 1
FLOOR DRAIN @ 0.50 ,,�� �!�/✓� ��� �� � ZA
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50 �: .d^"•-�? �p �� L�e�'Q-s
URINAL @ 0.50 .� _ i.a/. T!J_/S�G./.D-S•T J
- Q
HOUSE SEWER @ O.SO C/ iOw A ✓,•aI-..� T'c0 nf@.dtQ Z
MISCELLANEOUS / C�
0
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING - ! •~r1�
GAS VENT
i
CESSPOOL (d I;pp CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ) PIT ) @ I.00 SEWER
PERMIT . . I 1.00 GAS TEST / +L�✓ C SZ-
�� UTILITY CO.NOTIFIED {/ ..✓ re-
TOTAL FEE FINAL / ✓
'76A667-CE#817 6-65 eGPEERM-1.
APPLICATION FOR PLUMBI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER _
BUILDING AND SAFETY DIVISION BUILDING G' "
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN.W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE -
OWNERe
WATER CLOSET $1.25 MAIL
.BATH TUB 1.25 ADDRESS
CITY EL:.NO.
SHOWER 1.25
LAVATORY 1.25 CONTRA
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
LAUNDRY TUB 1.25 STATE LIC
LICENSE NO. Q +� CLASS
CLOTHES WASHER 1.25 DISTRI T NO. GRO Z E P BY
WATER H 1.50 r
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE.APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 ? INSPECTION RECORD V
O
E—
U
W
a
N
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING '
TOTAL FEE ' 0 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 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.
1 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 DESCRIBED RESID N AL PROPERT UTILITY CO. NOTIFIED
SIGNATURE
OF PERM I? �'-
FINAL
AI DATION
CK. M.O. CASH
LAUo.O 9' 9 2" APR 4 5 D 3.5 J