HomeMy Public PortalAbout5927 ROSEMEAD BLVD_Plumbing__ 76ASS7 11 2SM SETS 7-45 - -""--APPLICATION FOR PERMIT-
DEPARTMENT OF BUILDING AND SAFETY'. 1
COUNTY OF LOS ANGELES iLUMBI N 11 1
WILLIAM J. FOX, CHIEF ENGINEER
D 8 RICT NO. GROLIFE PERMIT NO.
FOR. APPLICANT TO FILL IN
M. • • / � '�r
PLUMBER '
(� Ave.NOTTINGHAM C
RECEIVE READ FOR DATE ISSUED
ADDRESS. - 123 No. Cloverly A ��
FIRST INSPECTION 2a
CITY TEMPLE CRY .CALIF. .1136
ADDRESS
COUNTY �
LICENSE NO. EXPIRES LOCALITYzrmndo & e.
ICERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NEAREST /q
ANGELES COUN LICENSE. CROSS BT dn-
eOWNER
;07MAIL
PLUMBER ADDRES
PERMIT FEE. IS $1.00 FOR THE FIRST FIXTURE OR CITY TEL No.
ITEM LISTED BELOW, PLUS BOO FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIALPROP-
ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE.
$1.00. MINIMUM FEE FOR ANY PERMIT $.1.00. EACH
GAS SYSTEM IS A SEPARATE ITEM.
OWNER
NUMBERTYPE of FIXTURE OR ITEM
WATER CLOSET (TOILET) CORRECTIONS
BATH TUB
SHOWER C�e S C G I'• V
LAVATORY (WASH BASIN)
KITCHEN SINK _
LAUNDRY TUB OR TRAY /
GAS SYSTEM OUTLETS
1
WATER HEATER
SLOP SINK Q
FLOOR SINK Z_
FLOOR DRAIN m
DISHWASHER Q'
O
DRINKING FOUNTAIN
URINAL
MISCELLANEOUS i
i
I -
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL
SEPTIC TANK - DRAIN ( ) PIT ( ) $ SEPTIC TANK
CESSPOOL $ SEWER
HOUSE SEWER $ .GAS TEST
TOTAL FEE UTILITY CO.NOTIFIED
t• FINAL
DEPARTMENT OF BUILDING APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES PLLJIMBING
NATURE OF INSTALLATION DISTRICT No. GROUP NO.
PERMIT No.
ROUGH � I K.
3
PLUMBING FIXTURES47�COMPLETE _ iY� 111
HEATER CESSPOOL SEPTIC TANK READY FOR = REC 1 ED DAT ISSUB�7
FIRST INSPECTION �/
GAS MISCELLANEOUS
Pff I—INTME=TO ED PORTION ONL
JOB
N NAME ADDRESS .•�
W
ADDRESS / 1� xI LOCALITY
Jv v NEAREST
6 CITY L. NO. CROSS ST. A
STATECOUNTY F
LICENSE NO. REG. NO. 19NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL O MAIL �Qb r/ J7gG"/
NORTH
CITY TEL NO.
CORRDMONS
A
Cys'-�—�y,�-R--`Id
F
I / � „i•, , ""7.,. rte/ VU
SOUTH I N 4a '` i' t "9-sir
DESCRIPTION OF WORK o
BATH TUB FURNACE
SHOWER _ DISHWASHER I n
LAVATORY REFRIGERATOR
y • q �j/��J� �..
KITCHEN SINK WATER SOFTENER' r !`� 7 �' �C Com,, t-•`/f,
FLOOR SINK SAND-TRAP
SLOP SINK OOR DRAIN
'WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY, ROUGH PLUMBING
OUTL SODA FOUNTAIN GAS PIPING
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES
SEPTIC TANK
SEPTIC TANK
.CESSPOOL F7 SEWER.
PERMIT FEE 1 OO UTILITY CO. NOTIFIED
TOTAL FEE I 1 `FINAL
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