HomeMy Public PortalAbout6164 LOMA AVE_Plumbing__ 76A667 DBB 17 11-50. s. �,,1,•` APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY,
COUNTY.OF LOS ANGELES PLUMBING I
WILLIAM J. FOX, CHIEF EN0INEER
• ISTR C .--N.O. OUP O PERMIT
FOR APPLICANT TO FILL IN
PLUMBER
W.
Ll.' {pt �., {}1�` RECE-IVED BY READY FOR DATE, ISS '
ADDRESS st• r•!- A 9 wYlt'11;+.�FrI I .F - FIRST INSPECTION'
BUILDINGRESS`
^CITY 1 �' _ .s. TE L..No.. D'U': .9 �, //,.
-ADD ,(y
COUNTY - �,,t - �'�F:`!•LOCALITY � A.
LICENSE _NO. ?��- - EXPIREBf��
t0' :..NEAREST-
PERMIT FEES - cRoss sr
OWNER grY�
•NUMBER TYPE OF FIXTURE OR ITEM - FEE"
MAI0v -
-. .. :. L ® :
WATER CLOSET(TOILET) @ 0.50 S ADDRESS -
BATHTUB- @ 0:50 .. CI-� f, TEL.- No. '
SHOWER'
.@ O.SOly7b 1
1 HEREBY ACKNOWL •DGE THAT I-HAVE READ THIS
LAVATORY (WASHBASIN) @ .0.50 APPLICATION AND STATHAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ O.SO AND WS PO
STATE EGULATING PLUMBING. - '
CERT FY
SBESS THE ABOVE VALID LOS
'LAUNDRY*T,UB OR TRAY @...0._50 ANGELES COUNTY-'LICENSE, OR 1 AM.,THE LEGAL OWNER
OF THE RESIDENTIAL-F PROPERTY,.DESCRIBED 'ABOVE. . _
GAS SYSTEM - OUTLETS- @ O.SO
SIGNATURE O
WATERHEATER @ 0.50 PERMITTEE
SLOP SINK @ 0.50 INSPECTION RECORD` .'
FLOOR -SINK @-0.50 '
FLOOR DRAIN @.-0.50. -
DISHWASHER
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 PIG' til/ 110,46&11+
HOUSE SEWER - @ 0.513A
,-/- Z
.MISCELLANEOUS -2-- �,S"L /_�l+i'"/ _ -.. �r/`� 7J_/ //O .� .,
O
'All) Old fl. PIE
W"J
APPROVALS
DATE INSPEC TOWS NAME
_ I -ROU GH PLUMBING
GAS'PIPING-
.: GAS VENT '..
_ -CESSPOOL @. 1:00 CESSPOOL _ -
SEPTIC TANK:, - - SEPTIC TANK
DRAIN O PIT ( ). @ 1.00 I. SEWER
PERMIT . . . . .. t 1.CIO GAS TEST
UTILITYCO.NOTIFIED
TOTAL FEE s �4
D.B S.-1725M SETS 6-46
?EPARTMENT ,OF' BUILDING ANI). SAFETY',
APPLICATION FQR PERMIT. a.
COUNTY OF LOS ANGELESTL
Wm.,J:'FOX.CHIEF ENGINEER
DISTRICTNATURE 'OF INSTALLATION
I .IV GROUP ZONE PERMIT. NO; '
441
ROUGH FIXTURES COMPI;ETE.
HEATER CESSPOOL -I SEPTIC TANK CEIVEWDY READI''FOR` .`DATE ISSUED
'FIRST INSPECTION
GAS- MISCELLANEOUS �-
e A�P1 PLICAIV'I' FILL,IN :I�EAVIY;Y: OUTLINED PORTION-ONL
.:NJOBAME � jti'�' ADDRSSG II
.,ADDRESS S '�;,: '�// :LOCAL►TY
L C17Y e!?� a*� �T,Et%,N CRoe BT....
f/
r COUNTY �
' -.CERT.No: - EXPIRES j X. ,NAMId
E
LOCATION OF SRPTIC,.TANK, OR CESSPOOL.
Z• MAIL ,.
O
NORTH' v.
ADDRESS
.CITY TEL.Nor
- I -AM THE LEGAL POSSESSOR OF HEABOVE -LOS
_ �:. �• " .� �, - -, - L .T
._ -
�A'NGELES COUNTY:CERT1 FIC TE OF QUALIFICATION.
PLUMBER
I AM-THE LEGAL OWNER OF THE":PROPERTY DESCRIBED
W
ABOVE
CORRECTIONS
f - ':SOUTH, J, ,
DESCRIPTION-OF WORK
Q
- - BATH,TUB. ., C7
FURNACE - • -
SHOWER' .. DISHWASHER'
LAVATORY REFRIGERATOR
KITCHEN SINKWATER SOFTENER'
FLOOR SINK, SANDTRAP
L.T.TALF.,
SINK, FLOOR bFFA1N.'TRAY . _: URINAL APPROVALS-CLOSET- DRINKING FOUNTAINDATE INsvecroR's NwME
HEATER DENTALLAVA '0RYROUGH PLUMBING
GAS SODA'FOUNTAIN'OUTL GAS'PIPING
GAS VENT'GEBSPOOL_NUMBER OFFIXTURES SEPTICTANKOOL SEPTIC TANK .SEWER- $ UTILITYCO.NOTIFIED
-
•.FINAL
76,A',667, rE 817 7=69 ;
•
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"'.APP KATION ';SOF I•'L�.1f :�ll\LC� F?EF�'IVII
,COUNTY OF LOS"`ANGELES
DEPARTMENT OF COUNTY,.,ENGINEER
BUILDING AND SAFETY .DIVISION]
BUILDING -
JOHN IA:lAMBIE COUNTY ENGINEER:: ADDRESS o / ,
COLEMAN W,. JENKINS:`S'uP T.'OF BUILo1N,G LOCALITY -" PCC
FOR APPLIC;4NT T:O•FILL`IN (PR NT OR TYPE) "NEARESY;
"CROSS"ST.
NUMBER ",. FIX TUFE R ITEM:, ',EACH FEE
OWNER
WATER,CLOSET: :1.50 L
2JF✓
fj
BATH T;UB 1:50 ADDRESS `
a,
SHOWER:: 1.50 ' ,
CITY TEL: NO
L ;��A
/ AVATORY 2,.50 Gj
CONTRACTOR
r' /d
--SINI{,
3 p
DISHWASHER, 1-.50, _j CITY��.� .`•• „/,. .TEL:-NO. 867Z
,CLOTHES WASHER ` .1:50: STATE - LIC
.. .. '_ -
LICENSE NO.' • ,/ CLASS;
SWIMMING POOL`RECEPT6R 1:'50 DISTRICTINO GROUPZO E '••P O ESBY
LAWN SPRINKLER SYSTEM ,2.004 !-5p
WATEklIHEATER.- 1'.50 -/ 'INDUSTRIAL' _ -
WASTE APPROVAL
-_ :GAS•SY,§T'EM ''� OUTLETS •1.50 - p D r
zD INSPECTION RECORD
.;. .OUTLETS,OVER '. -•.30
S PER SYSTEM - _
G.
L-
Phan check fee,2,5 of above.�See reverse: '
PLUMBING PERMIT ISSIIING=FEE 2 00 _
.r DATE 4 INSPECTORS 51
TOTAL FEE
. z
. a - � � ..� AP GNATU RE..'
Plan cheek a Iicant v9
RP. - ;✓ ,. UNDER$$"WORK e��'f G�
"N'airle i r,ROUGH PLUMBING
.Ad CICe SSr. Y V'• - GAS�I:PIHING
GAS`VENT ^ `
City Tel. No'. HOTnWATER'HEATER,"y
'.I HEREBY,-ACKNOWLEDGE,THAT,I 'HAVE-READ-:THIS APPLICATION, '
.AND, STATE THAT'THE ABOVE��IS^CORRECT ,>NO,AGREE-_TOS'COMPLY- ^PLUMBYNG`FIXTURES
�,WITH ALL. COUNTY-`_�ORDINANCES`,AND STATE LAWS REGULATINGTic - " e
`PLUMBING. i - - -. -
x, -. - GAS'-TEST'
-`hI.HEREBY.CERTIF.Y THAT qL.AM PROP RLY .REGISTERED AND/O,R:i :UTIILITY CO:'-NOTIF:I�ED
Y
O
4LOS^ANG -ES^C NTY',AND;STATE.OF "
'CALIFORNIA'OR:THAT'1 AM_.w _.O � " _
' OW R OF AND INTEND•:TO --
LICENSED AS REQUIRED BY
'THE L iDEN L!ROPERTY,.,•- -e FINAL `S
RESIDE IN.THE ABOVE DE 6CRIBED S
y -
SIGNATURE "-JA K,R;»A I.'L E'Nf SU PE.RVISI,N �? P.NICA L' G R
OF, PERMITTE
PERMIT VALIDATION 'c:K M':o cASFI s
PLAN CIIECK VALIDATION
CK. M o cAsr
_
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