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78A667-GE0817 4-64 /
APPLICATION FOR PLUMBING PER4fT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS L
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN RNEAREST
SS ST . 07
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET SI.2S 1AS MAIL
BATH TUB 1.2S ADDRESS
SHOWER 1.25 CITY TEL. NO. y
LAVATORY 1.25 S CONTRACTOR
SINK 1.2S ADDRESS
DISHWASHER 1.25 CITY L. NO. 1�
LAUNDRY TUB 1.25 CONT CTOR•S 4 STATE ❑
REGISTRATION NO. < COUNTY ❑
CLOTHES WASHER 1.25 DISTRICTNO. GROUP PROCESSWATER HEATER 1.50 b, E � , ONE
/
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL CL
O
WASTE APPROVAL
OUTLETS OVER S PER SYSTEM .30 INSPECTION RECORD U
O
F-
U
w
a
_ Z
AP VALS DATE INSPECTOR'S A1Awu
RE
PERMIT $ 2 00 UNDER WORK G '
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER '
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICE NSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF.AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RE DENTIA IP ROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE -
FINAL
LIDATION ROBERT A. WOOD
C�7111M.O. CASH SUPERVISING MECHANICAL ENG'R
u 4932 OCT15 5 0 4.50-
I Em?LC Gt T Y
76A667-CE817-8-58
1
APPLICATION FOR I PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION I BUILDING
IOHN A. LAMBIE, County Engineer ADDRESS 6,436 6 1,tIest
CASSATT D. GRIFFIN,Supt of Building LOCALITY -`
TemplP Cis
FOR APPLICANT TO FILL IN NEABEOSS sT. ?en
NUMBER FIXTURE OR ITEM
OWNER ;. RainsWATER CLOSET MAIL
BATH TUB ADDRESS arc
SHOWER TY 3F.I c TEL. NO,
LAVATORY CONTRACTOR pa r. n
ers
SINK ADDRESS 109207'--. arand
DISHWASHER CITY ,, `l t-; TEL. NO. 443-692-'
CONTRACQ
LAUNDRY TUB TOR'S STATE REGISTRATION NO. _ COUNTY
CLOTHES WASHER DISTRICT NO. GROUP SIE PROCESSED BY
WATER HEATER A lnemrmF
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
C� .BO PER ITEM
R FIXTURE $ rt,, DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I 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 UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
! SIGNATURE S FINAL i iL A-
OF PERMITTEE 6
ROBERT A.WOOD.
OF VALIDATION SUPERVISING MECHANICAL ENG'R
0m ,
U.o. CASH
D