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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGTnim
RUIMING AND SAFETY DMSION BUILDING
JDLIN A. LRMB� Ceo ADDNESS
C718BATT D GRIFFIN, BRp t! Bl Rdtep LOCALITY,
FOR APPLICANT TO FDS IN Nca�
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET
ADDRE 38
BATH TUB
Q1TL III.H0.
SHOWER
LAVATORY CONTRACTOR
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DISHWASHER CTT NO,
O
LAUNDRY TDB REGISTRATION NO. COUNTY
CLOTHES WASHER D1NO Tp I
ZON074
E By
WATER HEATER i•/�HM.�'rA�/
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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APPROVA DATE INSPECTOR!SIGNATURE
PERMIT S 2 00 UNDER a ORK /i" 10
TOTAL FEE v ROUGH PLUMBING
GAS PIPING
I HEREBY STATE THAT
THE
THAT 1 HAVE READ AGR ATO COMPLY
ANDWITH
HALL TXAT THE ABOVE IB CORRECT AND AWS TO COYPU GAS VENT F �
WITX ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AY PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AN THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE '
OF PERM] r
FINAL - q
mr VALIDATION ROBERT A WOOD
C[ ■ 0 CARR SUPERVISING MRCHANICA.ENG'R
M0695 �3 MAY12 5 A 12.00 x
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