HomeMy Public PortalAbout9222 BROADWAY_Plumbing__ iBAEB]-CE#BIT 9/63
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDBERS 9222 Broadway
JOHN A. LAMBIE. COUNTY ENGINEER n a
WILLIAM A. JENBEN, SUPT OF BUILDING LOCALITY Tem 1 C1t /
FOR APPLICANT TO FILL IN NEAREST-
CROSS SL
NUMBER FIXTURE OR ITEM EACH FEE OWNER J. B. Weber Dev, Go.
3 WATER CLOSET HI.25 3 75
IL
1 BATH TUB 1,25 1125 ADDRESS 5926 Temple City Blvd.
1 SHOWER 1,25 1125 CITY Te le City TEL. NO.
3 LAVATORY LYSZ 75� CONTRACTOBValle Plumbing Co. of Glendon
1 SINE 1.25 1 25 ADDRESS 442 W. Fleetwood Place
1 DISHWASHER 1.25 1 25 C'TY Glendora TEL. No. Ed 51293
LAUNDRY TVH 1.25 CONTRACTOR'S 209431 STATE ❑
REGISTRATION NO. COUNTY ❑
1 CLOTHES WASHER 1.25 1125 1 ISTRI T NO.i GROUP ZONE SBED BY
1 WATER HEATER 1.50 1 50 N(}/ --
1 1.50 1 550 INDUSTRIAL lr
GAS SYSTEM OUTLETS WASTE APPROVAL \ �O
1 OUTLETS OVER 5 PER SYSTEM .00 30u
INSPECTION,RECORD
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APPSOVAIts /�DATTEE INSPECT(3R'S SIGN T E
PERMIT J52 00 UNDER SIEAH WORK 15 65TOTAL FEE 05 ROUGH PLUMBING fid �j
GAS PIPING '
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT SLK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. 1 1
-1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANOI OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN. THE ABOVE DESCRIBED RESIDENTIAL PROPS RT Y. UTILITY CO. NOTIFIED
SIGNATURE �� ,//
OF PERMITTEE01! //-)&Y' FINAL
VALIDATION ROBERT A!WOOD
cK. M.O. CASH SUPERVISING MECHANICAL ENG'R
Lh1 o E. 7 7 3� FEB 19 5 D 1 9.05—
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