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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 10568 Danbury
JOHN A. LAMBIE, COUNTY ENGINEER anry
DING
LOCALITY Temple City
WILLIAM A. JENSEN. SUPT OF Bw v [r
FOA APPLICANT TO FILL IN CROSSSST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER Noel Baldwin
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 , 3, ADDRESS
C17Y TEL. NO.
SHOWER 1.25 'Q
LAVATORY 1.25 -y 7.-I, CONTRACTOR Owen Bros Plumbing
SINK 1,25 1 ADDRESS )1265 No- B
aldwin
DISHWASHER 1.25 • j CITY El Monte _ TEL. NO. 443-0078
LAUNDRY TUB 1.25 CONTIIACTOR'S STATE ,$J
REGISTRATION NO. ]_ l8 COUNTY ❑
CLOTHES WASHER 1.25 f-J .,_.
DISTMESSED
BY
WATER HEATER 1.50
GAS SYSTEM J OUTLETS 1'50 'Q INDUSTRIAL / O
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .20 INSPECTION RECORD u
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APPROVALS DATE INSPECTO_F S SGNATURE
PERMIT S 2 00 UNDER SLAB WORK g+r{� C T
ROUGH PLUMBING7r-() - —ZZ "
TOTAL FEE ;Lf —(JO
GAS PIPING
I 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
PLUMBING, HOT WATER HEATER
1
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AN THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE AS DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE /
_.. ,.., . .. . :..,. S'(A FINAL ld- '
LIROBERT A. WOOD U
M... C
cK. M.o. .sH SUPERVISING MECHANICAL ENG'R
L ,p S+ 2 2 7*Z My 22 5 D 2 0.0 0" E