HomeMy Public PortalAbout10102 LYNROSE ST_Plumbing__ 76AS67 OBS 17 11-60 APPLICATION FOR PERMIT
DEPARTMENT OF ANG AND SAFETY
COUNTY OFF LOS LOS ANGELES
STE
lTPLU
WILLIAM J. FOX, CHIEF ENGINEER
/ TR
FOR APPLICANT TO FILL IN
MBE 1r n RECEI ED BY READY FOR DATE ISSUED
VrILLEY _y I - I FIRST INSPECTION
ADDRESS s/
836E) EAST VALL r BUILDING
CITYn - TEL No. ADDRESS VV
ROSEADO
COUNY t
LICENSE NO. EXPIRES LOCALITY_ ✓
NEAREST
PERMIT FEES 7
CR13BB ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
WATER CLOBET(TOILET) Q 0.50 >a V MAILADDRESS
BATH TUB @ 0.50 '1 ' Cl EL
SHOWER @ 0.50 Sd I HEREBY AC NOWLEDGE THAT I HAVE READ THIS
1� LAVATORY (WASH BASIN) @ 0.50 Q Q APPLICATION A HTATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB O TRAY 0 0.50 [] ANGELES COUNTY LICENBE, OR I AM THE LEGAL OWNER
GAB SYSTEM OUTLETS @ 0.50 <_e SIGNATURE
THE REBIDENTI (2OPERTY DESCRIBED ABOVE.i
SIGNATURE OF I
WATER HEATAR @ O.SO O PERMITTE
SLOP SINK car 0.50 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN 0.50
DISHWASHER O.SO
DRINKING FOUNTAIN O.SO
URINAL 0.50 J
Q
HOUSE SEWER O.SO Z
MISCELLANEOUS 6
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING /
GAS PIPING
GAS VENT
CESSPOOL 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ). @ 1.00 SEWER
PERMIT . . I 1.00 GAS TEST
UTILITY CO.NOTI £D
TOTAL FEE __T$710O
FINAL