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7BAB67-CF817
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
SUD.DING AND SAFETY DIVISION rU°'DDa ss° J6WAf _
CMAD T.IIMBIE Comb
Tr a aROtPDT, RMv 1 mlamG LOCAf I1 r
FOR APPLICANT TO FILL IIT NEAREST
ExEARET
I
NUMBER FIXTURE OR ITEM OWNER r )
WATER CLOSET Km1�
ADDRESIS
33ATH TUB
CITY L x0.
SHOWER
LAVATORY CONTRACTOR GCti��
grr am ADDRESS $4,DISHWASHER CAr x0
C NTRA R S
LAaxDR:rBR aeamTBAnox xo /�+ 3
CLOTEMS WAS 1 DISTRI NOP '.FO P OCRBBRD BY
WATER BEATER .0
GAS ST8rEm INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
1 • OREDPIiraRR S I APPROVALS;: 1 DATE INSPECTOR l SIGNATURE
PERMIT $ 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING -
GAS PIPING
1 HERERY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
,AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS BEGULATINO
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AN PROPERLT REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAB TEST
CALIFORNIA OR THA 1 AY TXE LEGAL NEB OF THE ABOVE
DESCRIBED
Bf81DIN PROPERTY UTILITY CO NOTIFIED
SIGNATURE T Lk/
OF PERMI FINAL Z• +
®r VALIDATION ROBERT A WOOD,
SUPERVISING MECHANICAL EPIG R
M4 3 1 2n DEC 14 5 'A 3.00