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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER / -
BUILDING AND SAFETY DMSION BUILDING
JJOHN A. LAMBIE, County Engiaee ADDRESS
CASSATT D. GRDFIN, Supt of Building LOCALITYj-
FOR APPLICANT TO FILL. IN NEAREST �.
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
�y ,o
BATH TUB ADDRESS
SHOWER CITY J- TEL. NO. lo-
LAVATORY CONTRACTOR
SINK - ADDRESS
DISHWASHER CITY NO.
LAUNDRY TUB CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY El
CLOTHES WASHER DISTRIC NO. GROUP Z N P SSED BY
INDUSTRIAL
WATER HEATER -
GAS SYSTEM _
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
PER ITEM
OR FIXTURE $ DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING
TOTAL FEE GAS PIPING
I
HEREBY ACKNOWLEDGE THAT I HAVE 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LASTEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM T LEGAL OWN% OF THE ABOVE UTILITY CO.NO'T'IFIED
DESCRIBED RESIDENTIAL PROP
SIGNATURE , FINAL V'1 rt
OFPERMITTEE
ROBERTA.WOOD.
®, VALIDATION SUPERVISING MECHANICAL ENG'R
CR, M.0. CASH
! ID6675S:; ;-U-y19 5 A 3 .00 r
7t'a661 IT 2-62 TEMPLE CRTY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER a
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAM D COUNTY ENGINEER
WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH .FEE JJJJJJ
OWNER �1 iO wiy
WATER CLOSET 57.25 MAIL
�L , �b�+
BATH TUB 1.25 ADDRESS �•
SHOWER 125 CITY ���.f-/`TEL.
LAVATORY 125 CONTRACTOR
SINK 1,25 ADDRESS
DISHWASHER 125 CITY TEL. NO.
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER '1.25 DISTRICT NO., GROUP Z NE PROCESSED S
•
WATER HEATER 1.50 /Y ( (N•Y
GAS SYSTEM-OUTLETS1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD y
14 U 4/ o
r
V
W
a
z
APPROVALS ;2,46 A3 INSPECTOR'S//SIN
//GATURE
PERMIT $ 2 00 UNDER SLAB WORK �j,yA3 �•y.,
����y�� ROUGH PLUMBING
1 / x
TOTAL FEE �_ JV GAS PIPING J s
I GAS VENT
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLU MBI.G. / J
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
CE (Y 1 [ \a
LINSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE-OF GAS TEST g \
CALIFORNIA OR THAT 1 AM THE LCGAL OWNER OF ND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED DENTIAL P RTY. UTILITY CO. NOTIFIED
SIGNATURE • !�,�./�/'.I � dP.A
OF PERMITTEE FINAL17/ 0"�Sib t-S1N.. lf�
LID}ITION ROBERT GWOOD
MECHANICAL
cK. M.o, cnsH SUPERVISING MECHANICAL ENG'R
L1 00 3 8 8 JAN 0 5 D 3,5 t0