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APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES �`u�B'�� '
WN J FOX,CHIEF ENGINEER
NATUREINSTALLATION PimmulT NO.
N (�
ROUGH FIXTURES COMPLETE If-2- / D/
HEATER CESSPOOL SEPTIC TANKBY READY FOR OATS NIENED
FIRST INSPECTION
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APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
y. NAME d ADDREp
G ADDRES11 LOCALITY
CITY TEL N L CRROOSSSSBTMa
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OUNry CERT O EKPIR[S zL' NAYS 5*ZCA� Me
LOCATION OF SEPTIC TANK, OR CESSPOOL MAR
NORTH ADDRESS
CRY TEL No
1 L AM THE LEGAPOSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF OUALIFITtON.
N4YRSIM
PEITY
TY
I AN THE LEGAL OWNER OF THE FRODmC1UBm
ABOVE
0
CORRECTIONS
SOUTH
DESOUPTION OF WORK
TIE TUB FURNACE
Howoa DIellwweHEN
0
VATORT REFRIGERATOR
TTCHEN SINK WATER SOPTUNIR
R SINK Ra DTRAP
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BINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE IRTa•S NMR
WATER NEATER DENTAL LAVATORY ROUGH PLUMBING g
On w`w FOUNTAIN GAS PIPING
a"VENT
CISBPOOL
TOTAL NUMBER OF PIXTURIS SEPTIC TANK
ESSPOOL SEPTIC TANK SEWER
B
TOTAL FEE UTILrrV CO NOTIFIED
/
FINAL
o s nT APPLICATION U PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
J FOX CHIEF ENGI
NATURE OF INSTALLATION DISTRICT�1N�O GROUP ZONE GPERMIT NASD,
y' /,
ROUGH J '?
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PLUMBING FIXTURES COMPLSTR
READY FOR RECEIVED BY DATA IBBU
HEATID CESSPOOL SEPTIC TANK FIRST INSPECTION
OAS MISC0IAN000B
APPLJVANT FILL IN HEAVILY OUTLINED PORTION ONLY
NAME
Joe SO SPi ea
_ 1 ADDRESS
O ADDRESS .�L LOCALITY G /- , _e
NEAREST ,
CITYetzoTSL NO ,)) CROSS ST LN{P_A PyfA O' `�}"d 101.1
=UN NO EXPIRES ISM d NAME t)
LOCATION OF SEPTIC TANF, OR CESSPOOL ; AD[REq
NORTH— O i
CITY /L GL�C�LDd G� TEL No A 2-0"
CORRECTIONS
3 J
a
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n
i' o
1
SOUTH
DESCRIPTION OF WORK
TH Tun FURNACE
ROWER DISHWASHER APPROVALS
LAVATORY REFRIGERATOR DAT[ INJIrCCTOIIf NAME
KITCHEN SINK WATER SOFTENER ROUGH PLUMBING
FLOOR SINK RAND TRAP GAS PIPING
LOP SINK FLOOR DRAIN GAS VENT
WASH TRAY URINAL CESSPOOL
WATER CLOSET DRINKING FOUNTAIN SEPTIC TANK
WATER HEATER DENTAL LAVATORY SEWER
M[TER-l—GAS SODA FOUNTAIN UTILITYCO NOTIFIED
OUTL 7
FINAL
1 AM THE LEGAL OWNER OF THE 6 S ANGELES
COUNTY REGISTRATION H B
TOTAL NUMBER OF FIXTURES �T
SEPTIC TANK
ILUM1[11
85BP0 1 AM THE LEGAL OABO
Vic
6i1 OF PRO TY D BEr
TOTAL FEE 1 �"i