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DEPARTMENT OF COUNTY ENGINEER
PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING /
WILLIAM J FOX. COUNTY ENGINEER ADDRESS �f�
FOR APPLICANT TO FILL IN LOCALITY C'
BUILDINGNEAREST
ADDRESS 5554 Alessandro St. CROSSST
DISTRICT NO GROUP ZONE PERMIT NO
LOCALITY Temp18 Ci1ty � Eq
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NEAREST O `�
CROSS ST RECEV► ED BY Ready for Inspection DATE ISSUED
OWNER 7-2IS—,Y31
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
CITY TEL NO INSPECTION RECORD
PLUMBER T. J. HOLLIDAY 14
ADDRESS 5003 N. Camellia Ave. -
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CITY Te=le Cit EL NO AT 6-1754
EkSTATE
LICENSE NO C-36 92754 0 COUNTI J
PERMIT FEES a
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NUMBER TYPE OF FIXTURE OR ITEM FEE of
WATER CLOSET(TOILET) @ 080 $ 80
O
BATHTUB a 080
SHOWER @ 080
LAVATORY(WASH BASIN) @ 0 80 80
1 KITCHEN SINK @ 0 80 80
LAUNDRY TUB OR TRAY @ 0 80 180
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM OUTLETS @ 1 00 1.00
WATER HEATER @ 1 00 1100
MISCELLANEOUS
APPROVALS
DATE INSPEC OR S SIGNATURE
t UNDER SLAB WORK
PERMIT $ li 00 ROUGH PLUMBING i9 —
TOTAL FEE 7 00 GAS PIPING :::d R�j(.//SO wwlc -'Z"/
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI GASVENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES lI L2 S 4 �UILt�-"-
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
` ` / n��
OF PERMITTEE _ _ Y dl. (� Ir�F - FINAL l L L �4
76A667 DES 17 1/53 /
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