HomeMy Public PortalAbout5002 RIO HONDO AVE_Plumbing__ IW67A (aII�3178) -4177
APPLICATION FOR PLU PING PERMIT
BUILCIN AND SAFETY DMS IN
Al-
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS �L'-o /� ' D
WATER CLOSET
LOCALITY-,7!!5,/ ++`
BATH TUB NEAREST / _ ./
CROSS ST.L e
SHOWER OWNER ��
LAVATORY MAIL ADDRESS _
SINK CITY TEL.NO
DISHWASHER CONTRACTO ArJ
1
CLOTHES WASHER ADDRESS/47
SWIMMING POOL RECEPTOR
CITY b/� TEL.NO.
LAWN SPRINKLER SYSTEM STATELIC.
WATER HEATER LICENSE NO. CLASS C.r
GAS SYSTEM OUTLETS DISTRICT NO. UP7,QN4 PR CESSED Y
OUTLETS OVER `
5 PER SYSTEM INDUSTRIAL V
WASTE APPROVAL
INSPECTION RECORD
h
Z
�a
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
NOine D� APPROVALS. DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address —,-;y f ROUGH PLUMBING
City, C�ip //f Tel.No ,f 3 GAS PIPING p� -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT '
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULA ING. HOT WATER HEATER
I HEREBY CERTIFY THAT I A LY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS.ANGELES C TY AND 5 TE OF CALIFORNIA OR THAT 1 AM THE GAS TEST Q 71— -d�,
LEGAL OWN OF,AND T TO RESIDE I ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED .01
SIGNATURE
OFPERMITTEE FINAL -
PLAN CHECK VALIDA N cK. cASH PERMIT VALIDATION M.O. CASH
8 9 2 ti JUL 25 5 0 1'3-.0 0 ASS .
76A667 Des 17 11-50 APPLICATION FOR PERMIT
JPEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES g G 1
WILLIAM J. FOX, CHIEF ENGINEER
DISTRICT-NO. GROUP O .
FOR APPLICANT TO FILL IN a
`7 1JQ e /--1
PLUMBER READY FOR DATE ISSUED
RECEIVED BY
' � FIRST INSPECTION
ADDRESS 1
GG11 BUILDING
ADDRESS
CITY TEL N.1- 4
CNTY qq LOCALITY
LICEOUNSE NO. t.� EXPIRES Pd O'J��
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL �� `y�� �/�
WATER CLOSET(TOILET) @ 0.50 $ ADDRESS D �Ae S a-r.rki l"jG-A�i d s
BATHTUB @ 0.50 CITYQi�.G�e TEL N.DO'7:J
SHOWER 0 0.513 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
/ LAVATORY (WASH BASIN) @ G.SO 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.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY____@ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
GAS SYSTEM-3—OUTLETS @ 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
SIGNATURE
WATER HEATER 0.50 PERMITTEE
SLOP SINK @ 13.50 INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
'DISHWASHER 0.50
DRINKING FOUNTAIN 0.50
URINAL @ 0.50 'J
a
HOUSE SEWER @ 0.50 Z
MISCELLANEOUS 0
O
APPROVALS
DATE INSPEOTOR-B NAME
ROUGH PLUMBING
GAS PIPING de/1'/iO
GAS VENT �� !•�'
CESSPOOL @ 1.00 CESSPOOL (/
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) a 7.00 SEWER
PERMIT I 1,130 GAS TEST
TOTAL FEE
UTILITY CO.NOTIFIED s.!
5 �! �0
FINAL y