HomeMy Public PortalAbout8912 & 8912 1/2 BROADWAY_Plumbing__ 76A667-CE817-8-58
APPLICATION_ FORPLUMBING PERMIT .
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
BUILDING
JOHN A. LAMBIE, County Engineer
CASSATT D. GRIFFIN.Sup't of Building LOCALITY e 04 Q Iff e,
FOR APPLICANT TO FILL IN NST
CEAREROSS ST. �' b
NUMBER FIXTURE OR ITEM
WATER CLOSET OWNER d
BATH TUB
MAIL
ADDRESS f of () N A S
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR 1�
SINK ADDRESS / �� � !d 119 t&a yam-'
DISHWASHER CITY T e m,/01, ej i,f TEL. NO. el e7 7 ate`
CONTRACTOR'S ISTATE
D
LAUNDRY TUB REGISTRATION NO. .i1 7'6 j COUNTY ❑
CLOTHES WASHER DISTRLQT-NO. GROUP ZONE PR SSE Y
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
q/7- 9 El fin/ rr/{ IctGvIP L4-44_r
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APPROVALS
OR FIXTURE $
9 Q D DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING 91,
.r
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GASVENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER - �O
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I THE EGA L OWNER OF THE ABOVE UTILITY CO.NOTIFIED -47- b
DESCRIBED RESIDENTIAL OPERT .
SIGNATURE '
OF PERM ITTEE FINAL2-h
' ��/1i ��0
ROBERT A.WOOD.
OF VALIDATION SUPERVISING MECHANICAL ENG'R
CK B.0. CASH
LACc 1 9 6 8 SEP 1 5 A 11 .0 0