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DEPARTMENT' OF COIINTY ENGINEEIL 9
PLUMBING ■
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES FAB GORE .f
WILLIAM J. FOX, COUNTY ENGINEER ADORESS
FOR APPLICANT TO FILL IN LOCALITY • n / a
BUILDING ,/ p / NEAREST
ADDRESS 9�/ ry G � p�h(J lj//7f /1 /IJ A✓ CROSS ST.
LOCALITY Tom. M Iola /', �L.I/ / DISTRICTNO. GROUP ZONE PERMIT NO.
NEAREST /f —/ �
CROSS ST. RECEIVED
RoadY for Insoaatlan DATEISSUED
OWNER Jot 14 IH 1 'C. _ //- f- ✓
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
CITY TL M 0 I __ C'`l V T'EL.NO. INSPECTION RECORD
PLUMBER (-/JS eIt- d Jpp/J
ADDRESS 1 / I ;L ,yj I U)I U } I b (.0 fn ✓
CITY Te Mo �I. f ✓TEL.NO. l Q Q 7 ? 01&
State Contractor'License No.o I / Q (� Q I Class [, Cb fe J
L.A.County Contractor's
Q
ReRiatratlon Na. Z
PERMIT FEES t�
NUMBER TYPE OF FIXTURE OR ITEM FEE R•
J WATER CLOSET(TOILET) @ 0.80 $ 910 O
/ BATH TUB @ 0.80 go
SHOWER @ 0.00
J LAVATORY (WASH BASIN) @ 0.80 UO
I KITCHEN SINK @ 0.80 _J !7
I LAUNDRY TUB OR TRAY @ 0.80 _C! O
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR GRAIN @ 0.80
DISHWASHER @ 0.80 _
DRINKING FOUNTAIN @ 0.80 _
URINAL @ 0.80 J L� -
GAS SYSTEM------1.__OUTLETS @ 1.00 I PJV
WATERHEATER @ 1.00
MISCELLANEOUS APPROVALS
DATE INSPECTOR'S SIGNATURE
_ UNDER SLAB WORK I
PERMIT S 1 00 ROUGH PLUMBING I I
I
TOTAL FEE 7 60 GAS PIPING
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI. GASVENT pp
CATION AND STATETHAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATERTO
REGULMPLY WITH A ATING ATING PLUMBINGCOUNTY ORDINANCES AND STATE LAWS PLUMBING FIXTURES 11
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED I
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFO IA OR HAT IAM THE LEGAL OWN.
ER OF THE ABOVE D RI BE ESIOENTIAL PROPERTY. UTILITY CO.NOTIFIED u �-
SIGNATURE ` I
OF PERMITTEE.. -_.. .�R_
. _ .._-............._-._.-..... FINAL
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70A687 DBS 17 6/84