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-APPLICATIONS FOR PLUMBING PERMIT
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-DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING [�
JOHN A. LAMBIE, COUNTY�ENGINEER ADDRESS -J / =(✓1" '
' CASSATT D. GRIFFIN, SUP T OF•BUILDING /� f�
._... -. LOCALITY ,�' -
FOR APPLICANT<<TO .FILL IN NEAREST
CROSS ST.
E OWNER, 1 ✓ (� ppJ�. DISTRICT NO. GROUP ZONE READY FOR INSPECTION
ADDRESIS G_ - �15� J/?/
USTRIAL
CITY 't/ ..( L(/' 1 TEL. NO. I Z%- �^ WAD TE APPROVAL
PLUMBER t , L !� ZINSPECTION RECORD
ADDRESS
CITY,Z L. NNO 7 /�J ^gyp
LICENSE N9 n J- 0�1 ALY"/-i-. /D-.)/ /
NUMBER TYPE OF FIXTURE OR ITEM FEE
y WATER CLOSET (TOILET) @ S1.00 $
BATH TUB @ $1.00
SHOWER @ S1.00 '
LAVATORY (WASHBASIN) @ $1.00 -
KITCHENSINK@ 51.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00 ,
GAS SYSTEM .. @..$I.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
1 � _
UNDER SLAB WORK
PERMIT $ 1 00' ROUGH PLUMBING
GAS PIPING '
TOTAL FEE' 41 GAS VENT
'�I HEREBY ACKNOWLEDGE THAT )'HAVE READ THIS APPLICATION AHOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT,AND AGREE TO COMPLY -
WITH ALL COUNTY ORDINANCES AND• STATE, LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
`IHEREBY CERTIFY THAT 1 AM PROPERLY- REGISTERED AND/OR - GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF .
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE a UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROP Y.
i
,SIGNATURE
OF PERMITTEE FINAL
JOHN A. LAMBIE, COUNTY'ENGINEER - VALIDATIONROBERTA.WOOD,CHIEF PLBG. INSPECTOR
• CK. N.O, CNS. `