HomeMy Public PortalAbout5443 SANTA ANITA AVE_Plumbing__ wd1 1s WON ® SAFErT APPLICATION FOR PST
COMITY OF � ANGEM
OF NMMZMNG ANDPLUMBING 1
WILLIAM J. PDX. CHIEF ENGINEER
�SrRICT NO. GROUP ZONE PERMrr NO.
7=FOR APPLICANT TO FILL IN S^ � 4r O J-
1
UMBER 71RECEI m■Y RKADY POR DATE ISSUED
FIRST'INSPECTION
ADDRESS
IING
CITY T.L.T.L. )q, ADBULDDRESS Av
COUP I NO, 30000'
® LOCALPry rpA2blp d.-*
PSDRLT FSS
NUMEEE TYPE OF FIXTURE OR PRM PKE OWNER
7. F. Mailljoll
WATER CLOSET TOILET O.SO
ADDRESS Dd a 410 Arl
000- MATH TUN O.SO CITY&ANbit IS& TEL NO. -/JZ-V'
0.50 1 NE Y ACKN LEDGK THAT 1 HAVE READ THIS
LAVATORY WASH BASIN O. APPLICATION AND STATE THAT THE ABOVE 10 CORRECT AND
/ AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATK LAWS REGULATING PLUMING.
�• KITCHEN SINK O.SO 1 CERTIFY THAT 1 POSSESS THK ABOVE VALID LOS
LAUNDRY TU■OR TRAY O.S ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
OF THE RESIDKNTIAAyL PPROPERTY DESCRIBED ASOVE.
GASSYSTUTLETS O.SO SIGNATURE OF (� 7`.
WATER NEATER O.SO PRiNITTEE_ti
SLOP SINK 0.00 RZOM
FLOOR SINK 0.50
� ••� -.r/ +'-I.D C � SLS'
FLOOR BRAIN 0.50
DISHWASHER 0.00 �-�u•L Tr'r� a •I �aRG ` ��
DRINKING FOUNTAIN O.SO Te� e�•Y F
URINAL 0.50 ,J
HOUSE SEWER a 0.00
Z
MISCELLANEOUS O
OC
O
imovAIS
DATE INEPEOI'OR•E NAME
ROUGH PLUMING ✓ L rM�
GAS PIPING
GAS VENT
CESSPOOL 1.00 CESSPOOL
SEPTIC TANKI SEPTIC TANK
DRAIN ( ) PIT ( ) ® 1.00 S ER
PERMIT . • 1.00 GAS TOW
TOTAL FEE K 0 UTILITY CO. NOTIFIED . t
FINAL
'A667-CE817 12159 ,
APPLICATION OR PLUMBI G P.I�RI+III
COUNTY OF LOS ANGELES T
DEPARTMENT OF COUNTY ENGumEER aUILDnvG
BUILDING�iND 34FETY DIVISION 3UMDnADDRESS , y�3 Alf o a ✓�
JOHN A. MBI.. OUNTY ENGINEER
WILLIAM A.JENSEN..SUP!7';OF BUILDING
L'OCATITYANA e C;f
FOR APPLICANT TO IML.nq cR BT
NUMBER FIXTURE OR'ITEM
OWNER 7 `
WATER CLOSET Kam
RAW TUR A DDA DD S G d 4 F �r i ✓e
CITY T. ; TEL.NO.
J SHOWER
/ LAVATORY CONTRACT& d w g�-
SINX ADDRESS
DUIRWASRER CITY TEL NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUR REGISTRATION NO. COUNTY ❑
CLOTBES WASHER DIRCDT N GROUP
RO ZONE P CES$ED BY
WATER ABATER
LA
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD /
0
-f SI.00 PER TTBM �
OR FDCTU88 $ I �/ t/ APPROVALS
�G'.w r N DATE �,g INSP.ECTOR'S�,^-SSI�GNATURE
PERMIT $ 2100 UNDER SLAB WORK.`�v f, �i7( V jl Pc!r,' i
TOTAL FEE ROUGH PLUMBING y 3 6� k J
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE. IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER _
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM TIDE LES" OWNER OF THE ABOVE �y
DESCRIBED RESIDENTIAL PROP TY. UTILITY CO.NOTIFIED .'�. XIS I►k
SIGNATURE
OF PERM ITTE FINAL �I 6--fa r<< tp
Do ALIDATION ROBERT A.WOOD,
C,,u SUPERVISING MECHANICAL ENG'R
LAIC 1 0"5 9 �tUG 4 5 D 7.0 0