HomeMy Public PortalAbout9657 BROADWAY_Plumbing__ 76A667-CE#BI7 10-02 ��
APPLICATION FOR LUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING S()
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS t�J
WILLIAM A. JENBEN. SUPT of BUILDING LOCALITY T
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEET OWNER � ,
'� WATER CLOSET $1.25 - y J MAIL
BATH TUB 1.25 Z S ADDRESS S7•%�I
/
CITY TEL. NO.SHOWER � 1.25 s
'�. LAVATORY 1.25 sp
CONTRACTOR
SINK 1,25 ADDRESS Fi
DISHWASHER 1.25 CITY a4do .: TEL. O-Fd 73'71p2_
CONTRACTOR'S / STATE
LAUNDRY TUB 1.25
REGISTRATION NO. C'-3 6 l,?13 elle COUNTY
CLOTHES WASHER 1.25 L DISTRICT y0i C P ZONE CESSED BY
I WATER HEATER 1.50 , (Ay Al
CAS SYSTEM S OUTLETS 1.50 j 5D INDUSTRIAL IIL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD /J / ♦ V
I -
�lD�3 / , � 21 lir.neont� z_
% Q D APPROVALS D!AATTE�/ �IN.SLPEEC,T.OR'R•SYSIGHATURE
'PERMIT s 2 00 UNDER SLAB WORK Allow(/j
ROUGH PLUMBING ♦ �%� ��
TOTAL FEE / 06 GAS PIPING `G
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY 1 J♦JI
WITH ALL COUNTY oRDwwvices AND STATE uws REGULATING
PLUMBING. HOT WATER HEATER G.i.n 1/ ,♦
/tL.I
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AN./OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF I
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO GAS TEST
RESIDE IN, THE ABOVE DES CWBED RESIDEN A PROPERT UTILITY CO. NOTIFIED
SIGNATURE (�
OF PERMITTEE _ FINAL
ALIDATION ROBERT A. WOOD
M.O. CASH SUPERVISING MECHANICAL ENG'R
LAAO 1 0 1 9; FEB 18 5 D 1 5 .0 0