HomeMy Public PortalAbout5947 ROSEMEAD BLVD_Plumbing__ 76AS67A (CE 81713) —1/77 �( _
APPLICATION FOR PLUMBING. P,/EPMIT `(uI
d
BUILDING AND SAFE DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPEI BUILDING /jZ
NUMBER FIXTURE OR ITEM ® FEE ADDRESS 77
WATER CLOSET LOCALITY LO �•
BATH TUB NEAREST
CROSS ST.
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY �' EL.NO.
LAWN SPRINKLER SYSTEM STATE LIC.
WATER HEATER LICENSE NO. CLASS
GAS SYSTEM. OUTLETS DISTRICT NO. O.0 R ED BY
OUTLETS OVER O C3
5 PER SYSTEM INDUSTRIAL v
WASTE APPROVAL
INSPECTION RECORD
v
W
CAI
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE$ '70
Q
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address e 117
ROUGH PLUMBING
City Tel.NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE GAS VENT
THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE'LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA R THAT 1 AM TE
GAS.TEST
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESC ED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.Q. CASH PERMIT VALIDATION CK. M:O. CASH
c
.2- :5 :3 rJUfl .28 5 u'. 1 0'A 0 A%
yeaea� rr APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELESI
WILLIAM J. FOX. CHIEF ENGINEER
FOR
/iAPPLICANT TO FILL IN DISTRICTNO. GROUP I ZONE PERMIT
PLUMBER ��J�J fjt/� .� //1` � +•� CEIVED BY READY FOR o�jDATE ISSUED
-_ _ ^ aw'd "f FIRST INSPECTION Il®�o
ADDRESS ��� � /� c� ^ �Q �f �p
A 4 Sr _ADDRESS
Cp / /V® �at�I'V'
CITY TEL. lOjQ
COUNTY
LICENSE NO. EXPIRES ' rfo� LOCALITY P� �/
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) @ 0.50 S ADDRESS
BATH TUB @ 0.501 1 CITY TEL. NO.
SHOWER 0.50 I _<J 4 ( 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 AND
KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY (� 0.50 I ANGELES COU LICENSE. OR 1_ AM THE LEGAL OWNER
OF THE REBID NTI PROPERTY��M CRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.501
SIGNATURE OF tc�l
WATER HEATER A 0.501 PERMITTE
SLOP SINK INSPECTION R ORD
FLOOR SINK @ 0.50
FLOOR DRAIN 0.50 � �����
DISHWASHER @ 0.501 C /r �G�>
DRINKING FOUNTAIN fl 0.501 ���-"'ri- = '�` Q-7 (`�� Cl_;/G J /c%
URINAL (n) 0.50I
HOUSESEWER 0.501 Z
MISCELLANEOUS ()'
1 O
1 APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
1. CESSPOOL ( 1.001 CESSPOOL
SEPTIC TANK: 1 SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 I SEWER
PERMIT . 1.00 GAS TEST
�.eq1 UTILITY CO. NOTIFIED
TOTAL FEE I $
FINAL