HomeMy Public PortalAbout10685 LORA ST_Plumbing__ D.B.13,17SM sETs 2-47 t APPLICATION ION FOR PN '1°
'YDEPARMENT OP BUILDING AND SAB'
COUNTY OF LOS ANGELES.•
VVM..J. FOX..CHIEF ENGINEER a ��
- NATURE ®F INSTALLATION ®ISTezrca Flo. de�oojP �. PERMIT NO.
ROUC3H FIXTURES COMPLETE +' Com/IC6PCs
CEI ' BY READY.FOR. '• DATE ISSUED
HEATER - CESSPOOL —I
BE RANK FIRST INSPECTIOF�1
AS' MISCELLANEOUSorm '0 ' l ' -
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
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d. .NAME t.-..ems.._ a ADDRESS Ew7fS�tfa'fx� st'�K�
ADDRESS= LOCALITY
J _ -NEAREST
p CITY TEL.No. CROSS ST. t Xj
COUNTY
CERT.NO. ryry EICPIRES p,,� 6 . .NAME +� �.��/!e'�, �•.t.g!s.+d-L/
LOCATION ®F SEPTIC-BAN�y,OR�iEP�/'WIi. Ilii MAIL dr/
ADDRESS 6 ® cwi :-7 A66+S>`P..CsL-� .
NORTH O . y� .y�
CITY :/�'_� _L_,l d _� lii LFL.No.
1 AM THE LEGAL POSSESSOR .•`F THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF4UALIFICATION.
lid
• PLUMBER
I AM THE LEGAL OWNER OF'THE PROPERTY DESCRIBED
ABOVE.
• - - - J .�-� OWNER
- CORRECTI®NS
SOUTH I
DESCRIPTION OF WORD
BATH TUB -FURNACE r CJ
�I SHOWER ISHWASHER. r p
LAVATORY •REFRIGERATOR• ,-
/ KITCHEN SINK WATER SOFTENER
aLOOR'SINK SAND TRAP
SLOP SINK - FLOOR DRAIN
WASH TRAY URINAL APPROVALSWATER CL OBEY DRINKING FOUNTAIN ' DATE INSPR&OW8 NAME '
• WATER HEATER DENTAL LAVATORY ROUGH.PLUMBING
ETER—K-GAS QODA FOUNTAIN
- OUTL GAS.PIPING ,
GA8 VENT I
CESSPOOL-
TOTAL NUMBER OF FIXTURES SEPTIC TANK.
CESSPOO[ SEPTiC TANK / O SEWER I' -
B UTILITY CO.NOTIFIED h i I
[T70TA:lL. FEE.
'] INA
J �7• A•667 fC�E-3;17�?,✓72., � r-- _ .- •
/ ' v ; C. _
APPLIC OR PL - . B.ING PERMIT .
COUNTY OF LOS ANGELES '
DEPARTMENT OF COUNTY ENGINEER I
BUILDING AND.SAFETY DIVISION
MAKE CHECKS PAYABLE TO. 7ADDRE
HARVEY T. BRANDT, COUNTY ENGINEER'FOR APPLICANT TO FILL IN (PRINT OR TYPET NUMBER' FIXTURE OR ITEM @ FEE
WATER CLOSET 1:75 r
BATH TUB 1.75 ADDRESS
' SHOWER 1-.75 CITY' G 6,( TEL. NO: I _
�.'. f ?:5
` LAVATORY 1,75 CONTRACTOR
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY TEL. NO.
f
k CLOTHES WASHER 1•.75. STATE LIC'
LICENSE NO.. GLASS
SWIMMING POOLRECEPTOR 1.75
DISTRI T NO. GROUP ZONE OCESSED BY
� .
LAWN SPRINKLER SYSTEM 1.75 QQ•
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL O.
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD- v
OUTLETS.OVER
5 PER SYSTEM •30 7 LV-,91.4 11 W 65 l ,, o O
Cn
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Cn
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00.
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan Check applicant UNDER SLAB WORK :. n Qyr �
Name amu.
I ROUGH.PLUMBING
• Address ;GAS PIPING
City - Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND. AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. _ GAS TEST _
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED 'AND/OR .UTILITY CO. NOTIFIED
LICENSED AS RECIUIRED BY LOS'ANGEL'ES COUNTY AND STATE OF', h. ,
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND•INTEND TO. _
RESIDE IN THE ABOVE DESC ESIDENTIALPR PERTY. !FIN;AL'. '
/r
" SIGNATURE '
OF PERMITTEE _
PERMIT VALIDATION (/`�K/,+ CAGB`
PLAN .CHECK VALIDATION CK: M.O. CASH 1
: ''. IB--1-9" ,, 5, B ' \\\.1..1.? 5 ,&%,