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CE#817 9/63
APPLICATION FOR PLU SING PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
G WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
.NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1,25 ADDRESS
CITYTEL. NO.
SHOWER 1.25
LAVATORY 1.2S CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY L. NO. ,? ?
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION N0. COUNTY E]
CLOTHES WASHER 1.25 DISTRI T NO. GROUP ZONE P ESSED BY
WATER HEATER 1.50 �J � � �
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL 0-
WASTE
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT .$ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 6v GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION .r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT J
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
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1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AMM THE LEGAL OWNER OF,AND INTEND TO ` \ /
RESIDE IN, THE ABO=DES RE eDENTIAL PROPERTY UTILITY CO. NOTIFIED
SIGNATURE
FINAL
OF PERMITTEE ],194r
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ALIDATION ROBERT A. WOOD
• cK M O CASH SUPERVISING MECHANICAL ENG'R
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