HomeMy Public PortalAbout10153 LYNROSE ST_Plumbing__ 76A667C (CE-8178) -9/7S !J!YC�e
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APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ` +�
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY - MAIL
ADDRESS
SINK Q�� {f (� CITY TEL NO
DISHWASHER 00 CONTRACTOA
CLOTHES WASHER
ADDRESS/��
SWIMMING POOL RECEPTOR
CITY _ TEL N0� 3Q
LAWN SPRINKLER SYSTEMSTATE /fl
WATER HEATER , LICENSE NO 7"/(i CLASS
GAS SYSTEM OUTLETS �� DIST IICT NO. GROUP �/Z�NE RO SSS YOUTLETS OVER
5 PER SYSTEM INDUSTRIAL O
- WASTE APPROVAL V
W
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE �p `�
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address
INGHO
GH PLUMBING
City Tel NO PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICGAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CO
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULWATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ABING FIXTURES
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATEST ,Z,�� �"CALIFORNIA OR THAT I AM THE L ALOWNER OF, AW INTERESIDE IN THE ABOVE DESCRIBESIDENTRTYITY CO NOTIFIED
SIGNATURE
OF PERMITTEE L 77
PLAN CHECK VALIDATION cK M o CASPERMIT VALIDATION (C 1::).
o CASH
5 3'i--rEd 9 <5 U 1-6-5 0 =j
IGA687 n 8-30 APPLICATION FOR PERMIT
DEPARTMENT. OF BUILDING AND SAFETY - P L ' ,G
I j COUNTY OF LOS ANGELESimmll
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL INDIST,,RIICT NO. GROUP ZONE PERMIT NO.
- %'�,Q 9 /5"
PLUMBER CO. REC IVED BY READY FOR DATE ISSUED
FIRST INSPECTION _
ADDRESSFY,BLVD.
8309 �—�4ST VAI
BUILDING
CITY Ro SFMFAD TEL. NO. AT, 2-271.. ADDRESS
COUNTY /
LICENSE NO 93M EXPIRES 6'�O / LOCALITY
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER n
MAIL
y WATER CLOSET (TOILET) Q 0.50 $ 0 ADDRESS
�I BATH TUB Q O 50 Sd CITY . /TEL. NO
SHOWER @ O 50 D 1 HEREBY AC OW LEDGE THAT I HAVE READ THIS
Y LAVATORY (WASH BASIN) @ O 50 I ' APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ O 50 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ O 50 G. ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIA P OPERTY DESCRIBED ABOVE3
GAS SYSTEM —OUTLETS C� O 50
SIGNATURE OF r
WATER HEATER Q O 50 PERMITTEE
SLOP SINK Q O 501 INSPECTION RECORD _
ro-
FLOOR SINK Q O 501
FLOOR DRAIN Q O 501
DISHWASHER Q O 501
DRINKING FOUNTAIN @ O Sol
URINAL @ O 50I I .-I
HOUSESEWER Q O 501 I Q
MISCELLANEOUS I I 0
-I� O
I
I
APPROVALS
DATE
f� INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING /p�
GAS VENT f�M"``f�r
CESSPOOL Q 1 00 CESSPOOL
SEPTIC TANK- SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1 00I I SEWER
PERMIT . ( 1.00 GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE $ L
- � O FINAL I�