HomeMy Public PortalAbout6258 ROSEMEAD BLVD_Plumbing__ / 76A667 a17 O-SO.10
APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. Qat I ZONE PERMIT NO.
PLUMBER Lam. G/ 4 7' RECEIVED BY READY FOR DATE ISSUED
Dt p I� FIRST INSPECTION
ADDRESS �' J �" !r'e` An ►,/ ✓M ../4 4L �L�
jf'��y�o ADDREBUILDING
SS f/I \ /'✓� l .) �-
CITY' ��I /r`/�1/9� TEL NO.�"(� l.�J 1�5I
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COUNTY r LOCALITY C �
LICENSE NO. A EXPIRES L�A 7
NEAREST t9 L)
L)e_
PERMIT FEES CROSSST ,,ypam� `. ll JJ�� // �� �� /'�// A
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER lJ edllf m T- tot I� l I LOA ,
/ MAIL
/ WATER CLOSET (TOILET) Q O 50 S I�Q ' ADDRESS
/ BATH TUB @ O 50 I 4;C� CITY TEL NO.
SHOWER @ O 501 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) _ Q O 50 '�j APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
- AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK Q O 50 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
1 LAUNDRY TUB OR TRAY Q O 50 ---Q ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY
DESCRIBED ABOVE.
GAS SYSTEM=OUTLETS @ O 50 SIGNATURE OF ,Oit
WATER HEATER @ O 50 PERMITTEE
SLOP SINK @ o Sol INSPECTION RECORD
FLOOR SINK Q O 5o
FLOOR DRAIN Q O 50 1
DISHWASHER @ O 5o
DRINKING FOUNTAIN @ O 50
I URINAL Q O 50I i_n A �� J
HOUSESEWER @ O 501
Z
MISCELLANEOUS I I /y�.4j��b /) a
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APPROVALS
- c .Ylf DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1 00I CESSPOOL I V
SEPTIC TANK I I SEPTIC TANK -
I DRAIN ( ) PIT ( ) Q 1 00 SEWER A �r
PERMIT 1,00 GAS TEST F/ A vim• �� a
UTILITY CO NOTIFIED �ilfa pf I / A
TOTAL FEE I,$ S-0
FINAL