HomeMy Public PortalAbout6221 ROWLAND AVE_Plumbing__ 76A66VA
C$817(REV.6/7B)
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
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FOR.APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINS 6221 R041Lmd CG
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NUMBER I FIXTURE OR ITEM @ FEE ADDRESt
LOCALITY �-`�J
WATER CLOSET a
NEAREST
BATH TUB CROSS ST. ✓L Yaa ,L_
SHOWER OWNER SELOff.E.1d Martha.
MAIL
LAVATORY ADDRESS $ e
SINK CITY SO= TEL.NO.
DISHWASHER CONTRACTOR Trane BCC
CLOTHES WASHER ADDRESS ZQ34.N, Peck
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM ATE. r
WATER HEATER LICENSE NO. 265094 CLASS C-20
GAS SYSTEM OUTLETS 400 APPROVALS DATE INSPECTORS SIGNATURE
4 UNDER SLAB WORK
55 PER SYSTTELETS M
ROUGH PLUMBING
GAS PIPING
GAS VENT u
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST/P ub
Plan check fee UTILITY CO.NOTIFIED g
PLUMBING PERMIT ISSUING FEE$ _
TOTAL FEE V FINAL
Plan check applicant PLAN CHECK VALIDATION
Name
Address
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE �] 9 11
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2 1 A
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
0 0 0 0 0
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS _
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE q /�
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCR D RESIDENTIAL `q 0 O I a 0 0
PROPERTY.
SIGNATURE 0,0 0
OFPERMITTEE 0507-79 GLA 0 7—r7 n
DISTRICT NO ROCESSED BY ! 7
INDUSTRIAL
WASTE APPROVAL
76A667 OBS 17 7-31 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
F SR APPLICANT TO FILL IN DISTRICT NO. GROUPZONE PERMIT NEI.
1-5- 1 4s4o: s
PLUMBER RECEIVED BY READY FOR DATE ISSUED
- / KJ/J FIRST INSPECTION / n ��A 6L
ADDRESSA01221_, C7(
) BUILDING
CITY / TEL No. _ADDRESS (g
a.
COUNTY f O
UCENSE NO. G /+ � EXPIRES � LOCALITY
N—REBT
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) ® 0.50 B ADDRESS
BATH TUB @ 0.50 CITY TEL No.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0 O.BO AND STATE LAWS REGULATING PLUMBING.
1 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
I LAUNDRY TUB OR TRAY 0 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBE AB E. `
OAS SYSTEM MUTLETB 0 0.60 SIGNATURE OF
WATER HEATER (14 0.50 PERMITTEE
GLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN Q 0.50
DISHWASHER 0:50
DRINKING FOUNTAIN 0.50
URINAL (� 0.50 J
Q
HOUSE SEWER 0.50 _Z
MISCELLANEOUS m
hen" aza&wl LIZ �
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APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING D '"Z
GAB PIPING
GAB VENT
CESSPOOL 1.130 CESSPOOL
SEPTIC TANKi SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER
PERMIT .
1.00 GAS TEST F1W L -7,3 ,Ahl
UTILITY CO.NOTIFIED
TOTAL FEE B wu•�
FINAL
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