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6-60
APPLICATION FOR PLUMB[ G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING L� v
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. /
NUMBER FIXTURE OR ITEM OWNER _S
C� �/LI
WATER CLOSET MAIL
ADDRESS S
BATH TUB
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR e $
I smx
ADDRESS !� ~
DISHWASHER CITY <'o' _5.q� 1)�}QGt��(/� L. STATE
CONT
ACTOR'S
LAUNDRY TUB REGISTRATION ON NO. / O 7 / �`' COUNTY
/ CLOTHES WASHER DISTRICT NO. GROIN ZONE P t00 BY
WATER HEATER V ��
GAS SYSTEM INDUSTRIA
WASTE APPROVAL
INSPECTION RECORD
P.
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U
W 4
0
F
IXTURE
U
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ I Z 00 UNDER SLAB WORK
TOTAL FEE // Z-H S ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
L
CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
S REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
RESIDENTIAL P PERTY. -, 1 UTILITY CO. NOTIFIED
E �7 �ITTE r'i''`� FINAL
®rD VALIDATION ROBERT A. WOOD,
U.G CASH SUPERVISING MECHANICAL ENG'R
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.� - APPLICATION FOR LUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
77
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS o7
SHOWER 1.25 CITY TEL.
LAVATORY 1.2S CONTRAC Q
SINK 1.2S ADDRESS O D
DISHWASHER 1.25 CIT TEL. NO. 71
�� ,/
STATE LIC
LAUNDRY TUB 1.25 LICENSE N CLASS
CLOTHES WASHER 1.25 DISTRICT NQ. GROUP .ZONE P ES BY
WATER HEATER 1.50 �^ `J
1 50 AL
WASTE AINDUSTRPPROVAL r
GAS SYSTEM_OUTLETS C)
OUTLETS OVER 5 PER SYSTEM .30 If§PECWN PECUD
klzblU
W
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ry
CALIFORNIA OR THAT I AM T E LE L OWNER OF,AND IN ND TO GAS TEST l' j
RESIDE IN, THE ABOVE DESC BED IDENTIAL PR PERTr. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTE FINALIt` Z
VALIDATIJACK R. ALLEN
CK. M.0. CASH SUPERVISING MECHANICAL ENGIR.
Lhuo 4 4 8 9 PLAY 1 5 D .