HomeMy Public PortalAbout9566 WOODRUFF AVE_Plumbing__ D.B. 17-NSM SETS,a-43: APPLICATION FOR_PER$II'1'
DEPARTMENT OF BUILDING'ANI') SAFETY "
COUNTY.OFLOS ANGELES �L� ����
WM.J..FOX.CHIEF ENGINEER
NATUIIE OF INSTALLATION DISTRI .. Os IR*Ill ZONE - P RMIT O:
ROUEN XTURE6 _• COMPLETE' �_
HEATER CESSPOOL I SEPTIC TANK R ,EI ten, 'READY FOR ATI 18$YSI!
/zz �' PIRBT INSPECTION i r.
GAS- e� MISCELLANEOUS �""� �' `Mo1/` �
APPLICAN/T FILL IN HEAVILY OUTLINED'PORTION,ONL_Y .
JOB
NAME 7 °r -ADDRESS .A°�' �✓/ .ot!./q,+..s :9r y� .
ADDRESS v y - ..LOCALITY (` ^�`i i=! � - '� �✓.
�• CITY. TEL.No. - . CRo68 87'.
COUNTY
CERT.No. EXPIRES ' e�/
NAME
LOCATION-OF SEPTIC TANS, OR CESSPOOL'- 'z MAIL
NORTH O ADDRESS
.} _ CITY .. Je TEL.No.
I AM THE,LEGAL-. POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
' PLUMBER '
VAM T14K LEGAL.OWNER OF;TAR PROPERTY, EBCRIBED
041
CORRECTIONS.
SOUTH tl J
DESCRIPTYON OF WORK � z_;
HATH.TUB —FURNACE. }� `` O
Z SHOWER" DISHWASHER / 'p
LAVATORY -REFRIGERATOR
i
KITCHEN SINK -WATER SOFTENER
FLOOR SINK SAND TRAP "
SLOP SINK FLOOR DRAIN V.
WASH TRAY URINAL APPROVALS
j WATER.CLOSET` DRINKING FOUNTAIN DATE INSPECTOR'S NAME
--1—WATER HEATER DENTAL LAVATORY t I
ROUGH'PLUMBING
® METER 4� GAS SODA FOUNTAIN GAB PIPING I I
OUT.L
GAS VENT
CESSPOOL I'
'
TOTAL NUMBER OF'FIXTURESF- ,.Ii
� : SEPTIC TANKESSPOG SEPTIC TAE+° SEWERUTILITYCO.NOTIFIEDTOTAL.FEE
FINAL
7M7-CE817-B-58
comAvTPP LOS ANGEION FOR PLUMBING PERMIT
1 :.
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAM 13L County gnomes ADDRESS
TT D.GRIFFIN.Sugt of Building J
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
p
NUMBER FIXTURE OR ITEM CROSS or.
OWNER
WATER CLOSET
MAIL. e
BATH TUB ADDRESS
SHOWER QTYCZL.TEL.NO.
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY 1 TEL NO. 44
LAUNDRY TUB CONTRA TOR' ��jj �r �jj STATE
REGISTRATION NO. ��i r/ Jed COUNTY ❑
CLOTHRS WASHER DISTR ro. GROUP I ZONE eP H
WATER HEATER
GAS SYSTEM MDUS72M
WASTE APPROVAL
INSPECTION RECORD
4' n err' L Flei`
$$II APPROVALS '7-� o r0&*
@oau $ I �c� .
DATE INSPECTO 'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE �P 0 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ _u f'• 4
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST �� 1P
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENT! L PR .ERTY.
SIGNATURE
OF PERMIE FINAL
ROBERT A.WOOD.
®� VALIDATIOSUPERVISING MECHANICAL ENG'R
CK. H.o. CASH
LAC0 6 4 9 0 A "Ay 15 5 A 9.0 0 M