HomeMy Public PortalAbout5621 PAL MAL AVE_Plumbing__ 7"b Dm.> II-= APPLICATION FOR PERMIT
DEPARTI ANT OFiG AND SAFETY L B I� B I I�G
COUNTY LOS ANGELES
WILLIAM J..OF
LOS FOX, aHICF crlolNsew
DISTRI� Ivul. GROUP ZONE PIE
FOR APPLICANT TO FILL IN j/ ,,7 rF
PLUMBER RED D BY ry R IN6407I0N DAT[ ISSUED
ADDRESS
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CITY TEL No 7
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COUNTY LOCALITYEXPIRES NEAREST
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QR06S ST ` �✓ _ ��9
PERMIT FEES
MYM�FK Tri.[OI II%TIIKE DR ITd FEL DWHER
MAIL r
WATER CLOSET(TOILET) O 050 B ADDRESS :
BATH TUB O O 6D CITY TCL No
SHOWER O O6O 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) O OBD I Q APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT
AND ABRKE TO COMPLY WITH ALL COUNTY ORDINANCES
PLY
KITCHEN BINK O 050 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABLI
ABOVE VAD LOS
LAUNDRY TUB OR TRAY O O 6O ANGELES COUNTY LIC[NBE, OR 1 AM T E LEGAL OWN[A
OF THE RESIDENTIAL PROPERTY D ASOVL I
DAR BYST[M_OUTL[T! @ CSO /
WATER HEATER O 050
SIGNATURE OF k r
PtAMITT[
SLOP BINK @ D BD INSPECTION RECORD
FLOOR RINK O 1350
FLOOR DRAIN @ 0.50
DISHWASHER O ow
DRINKING FOUNTAIN O 050
URINAL O 0.60 A
I
HOUR[ SEWER @ 0.60 =_
MISCELLANEOUS
C
O
APPROVALS
DATE IN6Rl wm NAM[
ROUGH PLUMBING
DAB PIPING
GAS V[MT
CESSPOOL O 100 CESSPOOL
BEPTIO TANKS SEPTIC TANK
DRAIN ( ) PIT ( @ Too SEWER
PERMIT 1 w oAB TEST
S
UTI LrrY C0.NOTIFIED
O
TTAL FEE $�