HomeMy Public PortalAbout9707 BROADWAY_Plumbing__ 76A667-CESI7 3-59
APPLICATION FOR PLUMBING PERMIT �]
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County E.Vno- ADDRESS7,7�
CASSATT D. GRIFFIN, Sup t of Building yOCALITY _ / A
FOR APPLICANT TO FILL IN NEAREST
_ CROSS ST. / GL—
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY NO.
CONTRACTOR _
LAVATORY _
SINE ADDRESS
DISHWASHER CITY i'K NO. b Z'l q Q l
CONTRACTOR'S / y STATE
LAUNDRY TUB REGISTRATION NO. /3G 1-� O COUNTY ❑
CLOTHES WASHER DISTRICTNO. GROUP ZONE P
WATER HEATER I .
. GAS SYSTEM INDUSTRIAL -
WASTE APPROVAL
INSPECTION RECORD
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FT0 $1.00 PER ITEM $
OR FIXTURE APPROVALS DATE wIeNSSPEC�TO.GR'S SIGNATURE
PERMIT S Z 00 UNDER SLAB WORK .4� • L 1y"b11W
TOTAL FEE ROUGH PLurd GING
GAS PIPING JPB(J `,� - ✓`� /` J.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PPLICATION �_ I
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 L-Z SSzI G/I
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST / / L •�-P?SG .E/.
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE �e
DESCRIBED RESIDENTI PROPIElllRTY. f 3 UTILITY CO.NOTIFIED - O /•Yi 1Fw
SIGNATURE +_� �-- ��
OF PERMITTEF
_ FINAL •�B _
®. VALIDATION ROBE TA
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