HomeMy Public PortalAbout9428 BROADWAY_Plumbing__ °Bq°BT DBG.IT( APPLICATION FOR PLUMBING PERMIT
D1
IVISION OF BUILDING AND SAFETY
Deportment of County Engineer _
County of Los Angeles rBUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN, SUP TOF BUILDING
LOCALITY �4
FO APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER � 5. DISTRICT NO. 'GROUPI�� READY 'OR INSPEcn ON
MAIL
ADDRESS
d INDUSTRIAL
CITY EL,.NO. !/ WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY TEL. NO.
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATHTUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ SI.00
KITCHEN SINK @ 91.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ S1.00 _
CLOTHES WASHER @ 31.00
WATER HEATER @ $1.00
GAS SYSTEM @ 51.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Y PERMIT S 1 00 ROUGH PLUMBING
— GAS PIPING I
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
` WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
£ PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE
CALIFORNIA Oft THgT 1 AM E LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDER IAL P RT/Y/
SOF PERMIT'TEL FINAL
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A.WOOD. CHIEF PLBG. INSPECTOR
CX. Y.•. CASH
(.ACo 9 0 3 0 SM 10 3 2.0 0 m