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APPLICATLON FOR PLUMBING 'PERMIT
° COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS 10561 BO ue
JOHN A. LAMBIE, COUNTY ENGINEER g
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
Tem a'/City
FORAPPLICANT TO FILL IN NEAREST
EARS ST .
NUMBER FIXTURE OR ITEM EACH .FEE CROSOWNER Noel Baldwin
WATER CLOSET ;1.25 3 7' MAIL
1 BATH TUB 1.25 1 ADDRESS
2 SHOWER 1.25 2 50 CITY TEL. NO.
LAVATORY 1.25 3 75 'CONTRACTOR Owen Bros Plumbing
1 SINK 1.25 1 25 ADDRESS 4265 No Baldwin
1 DISHWASHER 1.25 1125 CITY El Monte .'TEL. NO. 443-0078
CONTRACTOR'S STATE
LAUNDRY TUB 1.25 REGIS RAS ON NO. 197181 COUNTY ❑
1 CLOTHES WASHER 1.25 DISTRI T NO. GROUP ZONE PROCE-SSED BY
WATER HEATER 1.50 1 50
1. 1 50 INDUSTRIAL _
GAS SYSTEM OUTLETS 50 WASTE APPROVAL `" O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
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APPROVALS DATE y INSPECTOR' SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING`-j,6 _2/ `
TOTAL FEE 20, 00 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
LLRESIDE
CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST
THE ABOV ES D RESIDENTIAL PROPERTY. UTILITY CO .NOTIFIED —1 4
EITTEE
FINAL r
ALIDATION ROBERT A WOOD
cK M o CASH SUPERVISING MECHANICAL ENG'R
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