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DEPAR'f`HENT OF 001T= ]ENC0412M PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
OOUNTY OF LOS ANGELES TBUILDINe
WILLIAM J. FOX, CouNY ENneE
IHR ADDRESS — 3
FOR APPLICANT TO FILL IN LOCALITY `�- C ,
NEAREST
ADDBUILRESS
S �gQ `' '^ S �9M) OR088 8T C
ADDRESS �y��JJ LCJ�-J-Y
LOCALITY
��M / /-�- DISTRICT NO. GROUP ZONE PERMIT NO.
Ara
NEAREST
CROSS 8T. CE1VED BY Reidy for lospoWe■ DATE ISSUE
OWNER `I
MAIL I DUSTRIA
ADDRESS g2ol 66&4AN0.Wj4K WASTE APPROVAL
CITY,�-: CLTX TEL,41a INSPECTION RECORD
PLUMBER
ADDRESSFn
Ca.ct
CITY TEL NO.
1 •/� d�
LICENSE N0. UPITY
PEHNIIT FEES �l sJ o i
NLJMi[R TYr% or rnxruwc oA rr[w F p
WATER CLOSET MILM ! L"i s
O
BATHTUB ! 0.30 d a
SHOWER ! 11.60 stA
LAVATORY(WASH BASIN) ! 0.60
ITCHEN SINK ! 8.80 Za
LAUNDRY TUB OR TRAY ! 0.90 D
i
SLOP BINK 0.60
FLOORRINK ! 060
FLOOR DRAIN ! O.SO 2
DISHWASHER ! 0.60 3 3 /
DRINKING FOUNTAIN ! 0.60
URINAL ! 0.60
GAS SYSTEM OUTLETS IAO
WATER HEATER
MISCELLANEOUS
APPROVALS
DATE INSPEOTOWS SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING D
TOTAL FEE a� BAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I
HEREBY CERTIFY THAT I AN PROPERLY REGISTERED
AND/OR LICENSED A8 REQUIRED BY LOS ANGELES OOUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AN THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PFtOPYM. UTILITY CO.NOTIFIED N est
SIGNATURE ,
OF PERYITTE
FINAL
TOA637 DM 17 1/63 r ,