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APPLICATION FOR PLUMBING PERMIT 1
Das 17 'DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of Loa Angeles BUILDING r/jJJ�� 1
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN,SUP T OF BUILDING
LOCALITY �!
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OWNER '- _V DISTRICT NO GROUP ZONE READY FOR INSPECTION
MAIL 7- I , I 4-1
ADDRESS v
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS Yalley Plumbing Co. of Glendwa
442 W Pleetwood Place CsS� /� lig_. �P G K I`sT) %rQ I Z.)"iE
CITY Gleed 00sfortu
LICENSE NO HDgewood 5-1293 n/T,� � -� R;; aJ&
NUMBER TYPE OF FIXTURE OR ITEM gFEE
Y WATER CLOSET (TOILET) @ $1 00 (i
BATH TUB @ $1 00
f SHOWER @ $1 00
�i- LAVATORY (WASH BASIN) @ $1 00
KITCHEN SINK @ $1 00
DISHWASHER @ 3100
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $1 00
WATER HEATER @ $100
GAS SYSTEM @ $1 00
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK A A
,'�j'
PERMIT $ 00 ROUGH PLUMBING �� t .,-
L
GAS PIPING
TOTAL FEE 4" GAS VENT _r
1 D HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER -v
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TESTLICENSED �' - Q
CALIFORNIAS ORE THAT D I BY
GELES THE OS NLEGAL OWNERY TE OF THE OF "L
UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY I
SIGNATURE
OF PERMITTEE �« FINAL
JOHN A LAMBIE COUNTY ENGINEER ALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
CK N 0 CASH
l
76234 APR 29 3 10.00 fn