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APPLICATION FOR PER4"eS
DEPARTMENT OFDING AND SAFETY
L{� I V
COOFF LOS ANGELES
WILLIAM J FOX CHIP ENGINEER
FOR APPLICANT TO FILL IN DIST RI O GROUP ZONE PERMIT✓DIO.
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PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED I3Y READY FOR DATE ISSUED
ADDRESS 900 CAT VALLEY BLVD.
/�vG FIRST INSPECTION
CITYROSEMEAD TEL No AT.2.2719 ADDRDESS
COUNTY
IO[6Y No 93M EXPIRES 6 30•.S'/ LoeAun ..r9 3
NEAREST
PERMIT FEES 'ROES ST i
Nump TYPE OF FIXTURE OR ITEM pEg MA NCR
MAIL
WATER CLOSET TOILET O EO f O ADDRCSS Y n� •%,.r,/rpt.ti' �f
/ BATH TUB ® O DO q �µy
TEL NOW b/
SHOWER O EO 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY WASH BASIN O EO O APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN LINK O E O STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY O E O ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDBNTIA PROPERTY DESCRIBED ABOVE,
OAS tYBT OUTLHTS ® O 00
WATER HEATER ® O EO SIGNATUREPERMITT F
BLOPSINK a O BO I INSPECTION RECORD s
FLOOR BINK 40 O EO
FLOOR DRAIN ® O Eo
DISHWASHER a 0 BO
DRINKING FOUNTAIN O EO
URINAL O EO ctnw
HOUSESEWER O EO Q
Z
MISCELJaNEOUB a
E
I
APPROVALS
DATE IN[P[GTOR[ MAM[
ROUGH PLUMBING
GAS PIPING
GAB VENT
CESSPOOL 100 CESSPOOL
SEPTIC TANK BEPTIC TANK
DRAIN PIT ( ) ® 100 SEWER
PERMIT 1 00 GAS TEST
TOTAL FEE 0
UTILITY CO NOTIFIED
B
FINAL
APPLICATION FOR PERMT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILUAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRI NO GROUP I ZONE PERMIT NO
+00.2 - i
PLUMBER ALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED
PIRST INGPSCTION
ADDRESS 8300 EAST VALLEY BLVD.
CITY ROSEtr M TEL NO AT. 2.2719 IODDREEBNBG j
C
�CHNTY SE NO '{^M EI( 1 6-��/ LOCALITY
NEAREST
PEBbIIT FEES CROSS BT
NUMBER TTFE or FIXTURE OR ITEM PEE OWNER
ov
MAIL
WATER CLOSET TOILET a 030 • ADDRESS g
BATH TUB @ O 60 Cl TEL. NO AVrO
SHOWER a O SO 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN O SO APPLICATION AND STATE THAT THE ABOVE IG CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN BINK O SO STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
R
LAUNDRY TUB OR TAY O BO ANGELES COUNTY LICENSE"OR 1 AM THE LEGAL OWNER
OF THE RESIDENT' PROPERTY DESCRIBED ABOVE
GAS SYSTENI-OuTLETS ® O BO SIGNATURE OF
WATER HBATHR O BO PERMITT
GLOP BINK a O BG INSPECTION RECORD
FLOOR INK 0 O BO
FLOOR DRAIN O BO
DISHWASHER O BO
DRINKING FOUNTAIN O BO
URINAL O BO .1
HOUGHSEWER O B O Q
Z
MISCELLANEOUS (�
O
APPROVALS
DATE INSPE T m B "AMC
ROUGH PLUMBING
GAB PIPING
GAG VENT
CESSPOOL 1 00 RD CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN f ) PIT ( ) ® 1 00 SEWER
PERMIT 1 00 GAB TEST
TOTAL REE So UTILITY CO NOTIFIED
FINAL