HomeMy Public PortalAbout9968 BROADWAY_Plumbing__ ^Pg7_Cr 17-8-58 _ v
APPLICATION FOR PLUMBING ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. County Ea in w ADDRESS `�/
CASSATT D. GRIFFIN,Sup t of Building
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MIUL
BATH TUB ADDRESS .
CITY TEL. NO.&J
SHOWER
LAVATORY CONTRACT
SINE ADDRESS) Q
DISHWASHER CITY /'Y�C �{j- TEL. NO. r1 sgg
CONTRACTOR'Sn STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTR�NO,.,( GR E ESSiP BY
R
WATER HEATER •r L C,1 (l([LJJ CC-P�,L,
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
!M APPROVALS
/ OFIXTURE PREm
$ /y V V
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING
TOTAL FEE -- GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
IHEREBY CERTIFY TH AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED Y S ANGELLES�,COU t TY AND STATE OF
CALIFORNIA OR THAT AM THE faAWt R OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENT L OPERTY /
SIGNATURE
OF FERMI T"FE FINAL -!7
®r VALIDATION ROBERTA.WOOD.
SUPERVISING
ING MECHANICAL ENG'R
CK. Y.O. CASH
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