HomeMy Public PortalAbout5503 PERSIMMON AVE_Plumbing__ N,,.,tl,. 1,7 a5M tlET9 7^47 SAFETY CATION FOR-PERBU
I.�PARTAIENT OF HUILDIN6'r AND t
COUNTY OF LO.g ANGELES <
WM.J.FOX.CHIEF ENGINEER PLUMBING '—
NATURE OF INSTALLATION DISTRICT NO. GR5UPT—ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE
NEATER CESSPOOL -I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
All- � MIHCELLA EOUB
APPLICANT FILL IN HEAVMY W INED PORTION ONLY
JOB � I�
C NAME o �y e y ADDRESS t
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Bm ADDRES83 _ //� LOCALITY
a zL
NEAREST
�I CITY hsA, la1 O _ CROSS 8T.
COUNTY �e
CERT.NO. EXPIRES l NAME e a
LOCATION OF SEPTIC IVANK, OR CESSPOOL 3 MAIL
8
NORTH °
d
1 AM THB EGAL POBB �OR TH6ABOVE L08ANGELES COU TY CERTIFIATL CATION.wMsmt
I AM THE LEGAL OWNER OF THB PROPERTY DESCRIBED
ABOVE.
._ OWNER
CORRECTIONS
SOUTH
J
,DESCRIPTION OF WORK a
z
BATH TUB FURNACE 0
ROWER DISHWASHER p
AVATORY REFRIGERATOR'
_KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
GLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET - DRINKING FOUNTAIN
• IfipO�PBCTOR'B NAME
WATER HEATER DENTALLAVATORY ROUGH PLUMBING
METEMAaGAB SODA FOUNTAIN GAS PIPING
OUTL
GAS VENT I
CESSPOOL I
TOTAL NUMBER OF FIXTURES SEPTIC TANK I I
CESSPOOL- SEPTIC TANK SEWER i
S
UTILITY Co.NOTIFIED I it j� I
TOTAL FEES FINAL I`�..--'�
PV COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETYp 5�7
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT N GROUP ZONE P .
V— yy _ -b
9.
PLUMBER��1�''RAL INSTALLATION CC) RECE VED BY FfRBEIN9PFE TION DATE ISSUED
of
ADDRESS 311 E. 80th STREET L. A.3
BUILDINGO d , -,I-,DITY TEL No. ADDRESS �j �C J
COUNTY p3 o LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES crtoss Br.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL Cts
WATER CLOSET(TOILET) (@ 0.50 ADDRESS IQ F.oR
- BATHTUB @ 0.50 CITY TEL. NO.
SHOWER 6110.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH SABIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSBEBS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICEN04 OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL RDE RISE' ABOVE.
OAS SYSTEM OUTLETS 0.50
SIGNATURE OF
WATER HEATER Q 0.50 PERMITTEE
SLOP SINK 0 0.50 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 'I
Q
HOUSE SEWER @ 0.50 Z
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAB PIPING
GAS VENT
CESSPOOL 7,00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER
PERMIT • I t.o0 GAS TEST l
TOTAL FEE M UTILITY CO.NOTIFIED
J I FINALi�✓Sc�
76A667 DBS.#17 6-58