HomeMy Public PortalAbout8948 BROADWAY_Plumbing__ .0,-17 APPLICATION FOR PLUMBING PERMIT
Dss.IP'�DMSION OF BUILDING AND SAFETY 1
Deportment of County Engineer
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
CASSATT D. GRIFFIN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER DISTRICT O. GROUP ZONE READY FOR INEPECt ION
ADDRESS 1527 Cypress Ave., INDUSTRIAL
CITY Los An Bles 65 TEL. NO. CA 52241 WASTE APPROVAL
PLUMBER nucy, PUBMING A MATTI10 INSPECTION RECORD
ADDRESS 3232 No. San Gabriel Blvde �y_ _�S/ GAS /1957"Ee A40 VA— U
CiTYSO San Gabel TEL NO AT60-4931 4/✓p e c, y cT _ a r--As _
LICENSE NO. /Cf W 4V /'f 8 4� c-F/
NUMBER TYPE OF FIXTURE OR ITEM FEE F �.1/� d/✓ >
WATER CLOSET (TOILET) $ _
BATH TUB
SHOWER _
LAVATORY (WASH BASIN)
KITCHEN SINK __ • `
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO. W 0.80 APPROVALS
UNDER SLAB WORK DATE INSPECTOR'S SIGNATURE
GAS�VSTEM�_OUTLETS ® 1.00 �_.
WATER HEATER c 1.00
ROUGH PLUMBING
PERMIT $ 11 100 GAS PIPING
TOTAL FEE 1 9
OD GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANC E5 AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REOUIREO BY LOS ANGELES COUNTY AND STATE OF UTILITY CO. NOTIFIED
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBEDEud
Nj,{Aj�,e y Y.& HE NO
SIGNATURE �1/UE9Y71 nriA
OF PERMITTEE FINAL
WILLIAM J. FOX, COUNTY ENGI ER VALIDATION
NC06 9 5 41S nuc 2 2 3 2.0 0�{/
BY \ ` (
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