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COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Dof County Engineer
DIVISIONSION OFF BUILDING 8t SAFETY
WILLIAM J. FOX, County Engineer PLUMBING 1
FOR APPLICANT TO FILL IN DISTRICT Na. GROUP I ZONE
PERMIT NU]?2s
2-7-
PLUMBE, tai jiAfi III RE� vI�/V READY FOR ED BY FIRST INSPECTION DATE ISSUED
ADDRES 3 ` Py Bi 1/ ' IJ7>/ /— ,9
BUILDING //ay IF
CITY ROSEPr1EADTEL NC T ADDRESS
COUNTY [[]] ddqq LOCALITY [ Cl
LICENSE NO.73M EXPIRE
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 02Z /// Pe♦lj
MAIL
WATER CLOSET(TOILET) 0 0.50 M ADDRESS
BATH TUB Q 0.50 CITY TEL No.
SHOWER G 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING.
1GCERTIFY THAT I POSBESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY ® 0.50 ANELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
SI THE RESIDENTIALOPERTY DESCRIB�D ABOV
GAS SYSTEM�OUTLETS 0 0.50WATER HEATER A 0.50 SIG P TIJMRE or -,eke ee
SLOP BINK 0.50 INSPECTION RECORD
FLOOR BINK 0.50
FLOOR DRAIN 0.50
DISHWASHER 0.50
DRINKING FOUNTAIN 0.50
URINAL 0.50 J
d
HOUSE SEWER 0.50 Z
MISCELLANEOUS 0
APPROVALS
DATE INSPECTORIS NAME
ROUGH PLUMBING .�
GAS PIPING
V
GAS VENT
CESSPOOL 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER /I
PERMIT • 1.00 GAS TEST n
TOTAL FEE _ g UTILITY Co.NOTIFIED
FINAL i
76AO67 DBS#17 6-5E
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
•
Departmentof CountyEngineer
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
DISTRICT NO. GROUP ZONE PERMIT NO.
FOR APPLICANT TO FILL IN _<
PLUMBERRECE VED BY READY FOR DATE ISSUED
VALLEY BOULEVAR8 PLUMBING FIRST INSPECTION
ADDRESS .�
BLVD.8300 EAST'VALLEY ADDR SS
CITY TEL.No. ff. 2-2719
ADDRESS
COUNTY LOCALITY e
LICENSE NO. EXPIRES r3 ag
NEAREST
PERMIT FEES CRO56 ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNr6R
MAIL
WATER CLOSET(TOILET) @ 0.50 Ill ADDRESS
BATHTUB 0 0.50 CITY TEL. No.
SHOWER 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 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 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED AB VE.
GAS SYSTEM--OUTLETS 0 0.50
SIGNATURE
WATER HEATER � 0.50 PERMITTEE
SLOP SINK 0.50 INSPECTION RECORD
FLOOR SINK Q O.BO
FLOOR DRAIN 41 0.50
DISHWASHER 6 0.50
DRINKING FOUNTAIN 0 0.50
URINAL 0.50 J
Q
HOUSE SEWER Q 0.50 Z
MISCELLANEOUS
a
APPROV,dLS
AT E, INBPECTOR'9 NAME
ROUGH PLUMBING
GAB PIPING
GAB VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) a 1.00 SEWER
PERMIT • 1.00 GAS TEST
TOTAL FEE D UTILITY DD.NOTIFIED /v/�'�G.- tz^
FINAL i+^ GGG'
7GA667 DBS#17 6-5E ,� '