HomeMy Public PortalAbout9642 BROADWAY_Plumbing__ 76AG, APPLICATION FOR PLUMBING PERMIT 1
D6a.IT IVISION OF BUILDING AND SAFETY
Depastmenl of County Engineer
County of Los Angeles BUILDING / 71
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN, SUPT OF BUILDING �j�
LOCALITY / j _
FOR APPLICANT TO FILL IN I NEAREST
CROSS ST.
OWNER ll), l+ . 1 f ly ( Q11A
DISTRICT NO. GROUP I ZONE I READY FOR INSPECTION
MAI L
ADDRESS 7�i' . �� P�0 2 AG(
•" p INDUSTRIAL
CITY ' Q / GF TEL. NO. WASTE APPROVAL
PLUMBER ..5�. G�w ID r //yINSPECTION RECORD
ADDRESS 6 ,(JOL° /'f^�CITY ?' / pTEL. NO. 9 / 6LICENSE NO. / G O b jNUMBER TYPE OF FIXTURE OR ITEMFEEWATER CLOSET (TO)LET) @0 S j EOBATH TUB @00 / 0 OSHOWER @00LAVATORY (WASH BASIN) @00 0 0KITCHEN SINK @0 ( C e)DISHWASHER @0LAUNDRY TUB OR TRAY @0 D OCLOTHES WASHER @0WATER HEATER @0 C'0 / B d
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 7 00 ROUGH PLUMBING Z ITU U
�j. GAS PIPING
TOTAL FEE d Da 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 1
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST ,+ V
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF U
CALIFORNIA OR THAT 1 A TH LEG OWNER OF THE ABOVE UTILITY CO.NOTIFIED CL
DESCRIBED RESIDENTIAL P TY.
SIGNATURE
OF PERMITTEE FINAL I L1 IL�
JOHN A. LAMBIE. COUNTY ENGINEER , 'VALIDATION ROBERT A. WOOD. CHIEF PLBG. INSPECTOR
'r, e... CAS.
4 4 4 5 JAN 2 4 3 8.0 0 In