HomeMy Public PortalAbout9635 BROADWAY_Plumbing__ 76AB67-CEB17 3-59
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. Couoty Eng 9j neer ADDRESS o v
GASSATT D. GRIFFIN, Sup' oI Building LOCALITY //
FOR APPLICANT TO FILL IN CROSSRST. , L K�-
NUMBER FIXTURE OR ITEM
OWNER
IL WATER CLOSET MAIL
ADDRESS
BATH TUB
i CTCV �' �f / TEL. NO. �S"��
SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER TiONT CTOA SATE
LAUNDRY TUB REGISTRATION NO. L COUNTY ❑
CLOTHES WASHER DISTRICT NO. G�R(,UP ZONE PR CESSED BY
WATER HEATER /+
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
2—X0 re&&/Q1eEFIkW`•W.12r
I' Q $1.00 PER ITEM
y J�
/ �r U o OR FIXTURE S /� Q APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER WO K
TOTAL FEE
b 0 ROUGH PLUMBING �/� � ♦�'/� �a Z
/� GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 9
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
CE
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE -
DESCRIBED RESIDENTIAL PROPERTY. UTI LITY CO.NOTI FIED / 4,7r�ai
SIGNATURE �,��/
OF PERMITTE L — FINAL.
®. VALIDATION ROBERT A. WOOD,
cC. m.o. Gstl SUPERVISING MECHANICAL ENG'R
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5548JAN22 5 A . 12.00 'A