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APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEAREST
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 0 N Agnes
WILLIAM A. JENSEN, SUPT OF BUILDING Tp le It
_ FOR APPLICANT TO FILL IN
NUMBER FIXTURE OR ITEM EACH FEE /
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OWNER__ R. Horton
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS gamp
CITY TEL. NO. At 6 F 2
SHOWER 1.25 •
LAVATORY 1.25 CONTRACTOR Pacific Installers
SINK 1.25 ADDRESS 10920 E. Grand
DISHWASHER 1.25 CITY Temple Cit TSL. NO. 442'-1234
CONTRACTOR'S STATE LAUNDRY TUB 1.25 REGISTRATION NO. 211-898 COUNTY �
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE ESSED BY
WATER HEATER 1.50 l O 7; /' 4 G E• a.}
50 INDUSTRIAL
GAS SYSTEM OUTLETS 1. WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .90 U
INSPECTION RECORD _-
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U
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT s 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE O GAS PIPING b-7
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
.
LS
CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES '
REQUIRED BY LOS ANGELES COUNTY AND STATE OFGAS TEST
R THAT I AM THE LEGAL OWNER OF.AND INTEND TOE ABOVE DESCRI ED RESIDENTIAL PRO UTILITY CO. NOTIFIEDTEE - ""-----' -
FINAL 4 -
ALIDATION ROBERT A. WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
U�L:o 3 6 0 3 DEC 2 3 5 D 3.5