HomeMy Public PortalAbout9320 BROADWAY_Plumbing__ 76A869 APPLICATIOiV FOR PLUMBING PERMIT 1
OBS IT(DIVISION OF BUILDING AND SAFETY ti
Deportment of County Engineer
County of LOS Angeles BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS � o �jE„LtAyW(,^1
CASSATT D. GRIFFIN, SUPT OF BUILDING
- - fl OCALITY
FOR APPLICANT TO FILL IN I NEAREST �C/��
CROSS ST. c
OWNER / �• DISTRICT NO. GROUP ZpN I READY FOR INSPECTION
MAIL '' II tE
ADDRESS
INDUSTRIAL
CITY TEL. NO. WASTEAPPROVAL
PLUMBER �:s-rL b'i3 r;J INSPECTION RECORD cn
ADDRESS ���G CSC t�AAu 6AZiEL- ! t� a71.—'1
CIT - -1 it 2 / 4 TEL. NO. &I-
LICENSE
_
LICENSE NO. /D cJ��� 't-.. ,lam A
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) . @ $1.00
BATH TUB @ S1.00 / +00
SHOWER @ $1.00 .w 00
LAVATORY (WASH BASIN) @ S1.00 caa 60
KITCHEN SINK @ $1.00 6 J /
DISHWASHER @ 51.00
LAUNDRY TUB OR TRAY @ $1.00 U
CLOTHES WASHER @ $1.00 Qd
WATER HEATER @ $1.00 CQ
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECCTOR.SSIGNATURE
UNDER SLAB WORK A y
PERMIT S 1 00 ROUGH PLUMBING
y GAS PIPING /
TOTAL FEE
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 ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR' GAS TEST L
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ^
CALIFORNIA OR THAT I AM THE. LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED L
DESCRIBED RESIDENTIAL PR PERTY.
SIGNATURE
OF RE TEE / L/NNN FINAL G r—
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLSG. INSPECTOR
CX. V.0. CASH
1{ 04 1 5 9-� NOV 8 3 1 3.00