HomeMy Public PortalAbout9659 BROADWAY_Plumbing__ 76A669 -CEA817 10.62 a -r_�
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES c✓uex
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BmLD1Nc 5 9 �t
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN. SOFT OP BUILDING LOCALITY f
FOR APPLICANT TO FILL IN REAREST •�
CROSS ST. i
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER
{� WATER CLOSET $1.25 Z j U
MAIL
! BATH TUB 7,25 2 ADDRESS
SHOWER 1.25
1 1 S CITY TEL. NO.
2 LAVATORY 1.25 Z ro CONTRACTOR
�. SINE 125 2.S' ADDRESS 2'
DISHWASHER 125 CITY Ole TEL..NO.�� )37f 2_
LAUNDRY 'IUB 1.25 R'.7 AT OTATE
CTON NO. C 6 T/ COUNTY
I CLOTHES WASHER 1;25 25— DISTRICT NO. GROUP ZONE ES
BY
/ WATER HEATER 1.50 _- l -C�frfl
GAS SYSTEM OUTLETS 1.50 V INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30
1 /
INSPECTION RECORD / U
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` O APPROVALS DDATE'I INSPECTOR'SSIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK �,/J�/rj j -v%—x;L",jj
ROUGH PLUMBING
TOTAL FEE �D GAS PIPING Y G
HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION GAS VENT
AND STATE.THAT THE ABOVE ICORRECT AND AGREE COMPLY
WITH ALL COUNTY ORDINANCES
S ANO STATE LAWS REGULATING HOT WATER HEATER /AA
PLUMBING. - y /�
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURESL/ ./1,y,N5
IC
LENSED AS REQUIRED BY L05 ANGELES COUNTY AND STATE OF GAS TEBT, �f
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO J�
RESIDE IN,THE ABOVE DE RIBED RESIO TIAL PROPERTY. UTILITY CO. NOTIFIED r3
SIGNATURE
OF PERMITTEE FINAL
ALIDATION ROBERT A. WOOD
.CAB. SUPERVISING MECHANICAL ENG'R
Vela1020-� FEB 18 5 D 15,00- 11