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DIVISION OF BUILDING ARID SAFETY
Department of County Engineer a, e. :•„ y
County of Los Angeles- BUILDING q
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS aZS �t�Mle.S �D f f/
CASSATT D. GRIFFIN,SUPT OF.BUILDING �. •�'.
.•..z -. -_ h. ....,. .., ,,..ff,.. ,......:- .., ., LOCALITY C //
ILI
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
t: OWNER 8/ DISTRICT NO. GROUP (Z� E� READY FOR INSPECTION
MAIL – /!/�
a; ADDRESS
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER ���•p� T—a j,,6 e_7INSPECTION RECORD
s. ADDRESS Q l��^ �•L "
CITY-`� / TEL NO-'A7-&0-Z_:?
LICENSE NO. -
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 O®
#, BATH TUB @ $1.00 Z1
SHOWER @ $1.00
LAVATORY (WA SH BASIN) @ $1.00 W
KITCHEN SINK .@ $1.00 c
DISHWASHER @ $1.00
'? LAUNDRY TUB OR TRAY @ "$1.00 'U
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00 / PIP
GAS SYSTEM @ $1.00 / D O
' APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 7 00 ROUGH PLUMBING Z `Cl 56 �ryi1.C ��4
00 GAS PIPING
TOTAL FEE GAS VENT /^
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES -AND STATE LAWS REGULATING PLUMBING FIXTURES -"V!7 :_�
7
PLUMBING. Y AJ .�
,L IHEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR GAS'TEST
d. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF L1
a CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE A VE UTILITY CO. NOTIFIED IA
DESCRIBED RESIDENTIAL ,pin Y.
SIGNATURE
OF PERMITTEE o: FINAL
JOHN A. LLAMBIE, COUNT ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. M.0. CASH.
CArt2220 JRW25 3 11 .00 tD