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76xe87 17 B-BO tD APPLICATION FOR PERMIT
' DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES P L I
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT O. GROUP I ZONE PERMIT NQ.
PLUMBERSVI �i 101 1 ����[13f ffc (f� RECEIV+ED BY READY FOR DATE ISSUED
ADDRESS
FIRST INSPECTION f '
CITY 'I /�/���� T.L. NO.! '�• (3� 1-3 ADD'ULRESS VVuu " ���J�1 _('fir �e
LCOUNTY CENSE NO. I o �// EXPIRES LOCALITY /e� --A`ZSJ. + 7'I-J - ✓'�
NEAREST
PERMIT FEES CROSS ST. 1
NUMBER TYPE OF FIXTURE OR ITEM F�EEZ OWNER Q``�T� J'1 S f1G�i CYI.
MAIL
WATER CLOSET (TOILET) @ 0.50 S fO ADDRES G3 no
I BATH TUB 0 0.50 CITY TEL. NO. a`
SHOWER .0.50 . 1 HEREBY ACKNOWLEDGE THAT 'I HAVE READ THIS
LAVATORY (WASH BASIN) 0.50 J APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 f a STATE LAWS REGULATING PLUMBTNt
1 CERTIFY THAT A[-PC S THE ABOVE VALID LOS
C� AM THE LEGAL
LAUNDRY TUB OR TRAY @O.50 ANGELES COUNTY OF THE RESIDENT'1,,ICE OPER
D CRIBED ABOVE. OWNER
GAS SYSTEM OUTLETS ® 0.50 �'
SIGNATURE pF
WATER HEATER @ '0.50 PERM'TT
SLOP SINK @ 0.50 INSPECTION RECORD `
FLOOR SINK Q 0.50
FLOOR DRAIN ® 45.50
DISHWASHER @ 0.501
DRINKING FOUNTAIN Q 0.501
URINAL @. 0'.50 ,J
HOUSESEWER Q 0.50 Q
z_
MISCELLANEOUS C�
a
0
APPROVALS
DATE INSPECTOR+S NAME
ROUGH PLUMBING An
r
GAS PIPING I I « Jv
GAS VENT
CESSPOOL 0 .1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) ® 1.00 SEWER
PERMIT 1.00 GAS TEST
UTILITY CO. NOTIFIED 1�..
TOTAL FEE
FINAL
V
i6Ass;Y-1505:7 7-5: APPLICATION FOR PERMIT J
DEPARTMENT OF BUILDING AND SAFETY ER m ffs ILI 0
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
/ DISTRICT GR UP ZONE .
FOR APPLICANT TO FILL IN /�
PLUMBER AX /.f�r� � RECEI� BY � �^ � L/� b
READY FOR ISSUED
ADDRESS 1 pt, IAL FIRST 17NSPECTIOfN� �p��
BUILDING 2-(� 11 A� �ATol dSY ek
CITY TEL.Na. ADDRESS .�y-• �.. o �I/
COUNTY LOCALITY f F-� q 4 ,t , c—/1 yr
LICENSE NO. EXPIRES y
NEAREST 1
PERMIT FEES CROSS ST. A J !
NUMBER TYPE OF FIXTURE OR ITEM FEE
OWNER (✓ a "•IAC {I'-
MAIL
WATER CLOSET(TOILET) a 0.5o 6 ADDRESS
BATH TUB 0 0.50 CITY TEL. No.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROP RTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS 0.50 SIGNATURE OF
WATER HEATER Q 0.5MITTE
0 PER -- m .
SLOP SINK 0 0.50 INSPECTION RECORD G
FLOOR BINK 0 0.50
FLOOR DRAIN IS 0.50
DISHWASHER Q O.$O
DRINKING FOUNTAIN 0 0.50
URINAL 0 0.50 J
/ a
HOUSE SEWER Q 0.50 Z
MISCELLANEOUS 19
Ix
O
APPROVALS
DATE INSPECTOR'S NAME
ROUSH PLUMBING
GAS PIPING
_ GAB VENT
CESSPOOL 6 1.130 CESSPOOL �J /� A
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) 411 7.00 SEWER ,v
PERMIT t.Do GAO TEST
UTILITY CO.NOTIFIED
TOTAL FEE 5 .c. sd
FI NAL
i
"6A8B7 " `
7BS.I7IC.58 APPLIC TI O. . P:L MB1NO
PERMIT .1 .
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County Of Los Angeles ' BUILDINCt
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS 4922 persimmon Ave
CASSATT D.GRIFFIN,SUPT OF BUILDING Temple Cit
LOCALITY y
FOR.APPLICANT TO FILL IN 1 CROSS ST. Keywest St
OWNER Lo Rosenburg
DISTgICT NO. CaBLiiiiP I ZONE IRE Y FOR INSPECTION
MAIL
ADDRESS Same v�OjJ `L
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER GENERAL INSTALLATION CO. INSPECTION RECORD
ADDRESS 6553 West Blvd.
CITY L.A. 43 TEL.NO. PLeasant 3-2541
LICENSE.NO. 737 C-36 151339
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @. $1.00.
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) .@ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM. @ $1.00
1 I WATER SOFTENER 1 00
APPROVALS
DATE, INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 21 00 ROUGH PLUMBING
GAS PIPING %
TOTAL FEE 00 GAS VENT J�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER i" 1
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY !!
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES I A
PLUMBING. FF t
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST S 1
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM E LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PRRI��
SIGNATURE ��.��
OF PERMITTEE FINAL
OHN A.LAMBIE.COUNTY ENGINEER LIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
• CB'. M.O. CARR
1 6 5 91' JUN 2 5 D. 3.0 0
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