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~"= APPLICATION FOR ' PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUMDING AND SAFETY DMSION F. Log
JOHN A.LAMBIE. COUNTY ENGINEER 5833 T=le City Blvd,
WILLIAM A.JENSEN,SUPT OF BUILDING
em le Cit
FOR APPLICANT TO FILL IN Tanis
NUMBER FIXTURE OR ITEM EACH FEE OWNER I
2 WATER CLOSET $1.25 2150 �'"
MAIL
BASH TUB 1.25 ADDRESS
CITY TEL. NO.
SHOWER 1.25
LAVATORY CONTRACTOR Van Caren Plumbing
SINK 1.2s ADDRESS 425 W. Chestnut St,
DISHWASHER 1.25 CITYKOnrovia TEL.NO.LM— 1
LAUNDRY TUB 1.25 ' ,REGIN STRATION NO: 191691 Cover
CLOTHES WASHER 1.25DISTRICT NO GROUP ZONE PROGESBED BY
WATER HEATER. C e ,1.50 1 -5b.
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GAS SYSTEM OUTLETS 1.50 ;-z. .��.AAPPROVAL pC Gs -.✓ -1 -6 3
OUTLETS OVER 5 PER SYSTEM .90 INSPEC/TIONjRECORD _ }
2 Drinking Founta ° 0
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APPROVf1/LS DATE INSPECTOR'S SIGNAT,IIRE
PERMIT $ 2 OO UNDER SLAB WORK
TOTAL FEE 1 Q, ROUGH PLUMBING I 27/6,: �-14L .
3 GAS.PIPING
I HEREBY ACKNOWLEDGE THAT 1 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" HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE AND/]
GA'S TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN.THE ABOVE DESCRIBED RESIDEIVIIAL PROPERTY. UTILITY CO.NOTIFIED /•�'
SIGNATURE ��1j'C�y 7 4 ,11�11 /.1
OF PERMITTEE FINAL
Co.-"LIDATION ROBERT WOOD v
CK� M.O. CASH SUPERVISI`G MECHANICAL ENG'R
Ul�o2 4 8 5: .KhR 25 5 D 13.5