HomeMy Public PortalAbout5640 PAL MAL AVE_Plumbing__ 76AGS7 n e-Eo rB APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICTNO GROUP ZONE PERMIT NO
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS / /f , '3r'/ U
BUILDING
CITY TEL NO •� � y ADDRESS
COUNTY
LICENS O EXPIRES LOCALITY
NEAREST
PERMIT FEES CROSS ST if
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL A /�✓� ^ Aye
WATER CLOSET (TOILET O SO S I/
ADDRESS
BATHTUB O SO
CITY TEL NO
SHOWER O SO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN O 80 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING
KITCHEN SINK O SO 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY O SO ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL R E ]BED A E
GAS
WATESYSTEM OUTL6TS ® O BO ��
SIGNATURE OF
R NEATER ® O SOI PERMITTE
SLOPSINK rEt O 60INSPECT( N RECORD
FLOOR SINK O SO
FLOOR DRAIN O SOI 1 U _1 I -�� NO�IQ aL Age
DISHWASHER O 60
DRINKING FOUNTAIN O EO
URINAL P O SOI J
HOUSESEWER O SO Q
Z_
MISCELLANEOUS l7
I
I I
I I
APPROVALS
DATE / INSPECTOR 9 NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL 1 OO CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( PIT 1 ® 1 00 SEWER
PERMIT 1 OO GAS TEST
,,1,,� UTILITY CO NOTIFIED
TOTAL FEE S Jr� [i() l
FINAL