HomeMy Public PortalAbout9509 PENTLAND ST_Plumbing__ 76A° " "H.` . T APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ��������
COUNTY OF LOS ANGELES
WN J FOX.CHIEF ENGINEER `
NATURE OF TIO DISTR O 9 PERMIT NO
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APPLICANTPLL
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NAME �� /LI��/iw AODREW D �C
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LICENSE NO' lzo EXPIRES C NAME
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LOCATION OF SEPTIC TANK, OR CESSPOOL �zr. MAIL
ADDRESS
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CITY TEL NO
I AM THE LEGAL PO88 SOR OF THE ABOVE LOO
ANGELES COUNTY CHRTIFI OF QUARIFICATIO
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IAM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
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TH TUB / vURNACH
OWHR DISH WASHER O
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S'^OR BINK BAND TRAP
LOP BINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET ^KINKING FOUNTAIN DATE IHSP[CTOR[HAMS
/ WATER H¢TER ^ENTAL LAVATORY ROUGH PLUMBING
HTHRIS' OAS SODA FOUNTAIN
OUTL GAB PIPING
OAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES 4 SEPTIC TANK
CESSPOOI SEPTIC TANK • SEWER
UTILITY CO NOTIFIED
FEE JS
FINAL
DEPARTMENT'OF COUNTY ENGINEER
11
PLUMBING 1
'DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING T/ Q/
WILLIAM J FOX, COUNTY ENGINEER ADO RE86 �/�7/✓
LOCALITY /
FOR APPLICANT TO FI L IN NEAREST
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? ADDRESS / DISTRICT NO GROUP ZONE UNITNO
LOCALITY `� ,� hZ/ �G S 7 9
NEAREST
CROSSST RECEIVED R"dYfar IneOection D TEISSUED
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ADDRESS WASTE APPROVAL
CITY TEL NO INSPECTION RECORD
PLUMBER _ �f " 7A'X/ A.$ =n42 d-IPAIR a
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CITY TEL NO `
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LICENSE NO ❑COUNTI J
PERMIT FEES a
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NUMR4R TYr[ OF FIXTURE OR ITEM FEC PJ
WATER CLOSET(TOILET) 0 080 1
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BATHTUB 0 080
SHOWER 0 080
LAVATORY (WASH BASIN) 0 080
KITCHEN SINK 0 20
80
'AUNDRY TUB OR TRAY 0 080
SLOPSINK 0 080
FLOORSINK 0 080
FLOOR DRAIN 0 080
DISHWASHER 0 080
DRINKING FOUNTAIN 0 080
URINAL 0 080
GAS SYSTEM OUTLETS 0 100
WATER HEATER ® 100
MISCELLANEOUS
APPROVALS
DATE INSPECTOR SIGNATURE
UNDER SLAB WORK n
PERMIT ; 1 00 ROUGH PLUMBING Al " - ..
TOTAL FEE OAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI CASVENT {y
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER /' L
IL
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AA A
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
Efl OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
BIG NATURE �_
OF PERMITTEE _ C C��'��1. /
-" FINAL
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