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APPLICAPION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION 'ATHENS'
JOHN A. LAMBIE. CouptF Eaginaer
CASSATT D. GRIFFIN.Supt of Buildi gr
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. _
NUMBER FIXTURE OR ITEM
MUUL we)
- u G a r/s
WATER CLOSET b1AI
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR Y� di e _ Plumbing
SINK ADDRESS -n
`
DISHWASHER CITY e � TaraEL. NO. OO1 .
CONTRACTORS--
LAUNDRY TUB REGISTRATION NO. CO '3
CLOTHES WASHERICOMPLY
DISTRICT NO. GROUP ZONE P CESSED BY
WATER HEATER \ I ys0..,`,��Q�
GAS SYSTEMINDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
PROVALS
OR FPIXTURE $ DATE I P TOR'S SIGNATURE
UNDER SLAB WORKPERMIT ROUGH PLUMBING
TOTAL FEEGAS PIPING
HEREBY ACKNOWLEDGE THAT 1 HAVE READ TGAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND Y HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LG
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 A THE L GAL OWNER OF THE ABOVE UTILITY CO.NC FIED
DESCRIBED RESIDENTIAL PERTY. A n
SIGNATURE INAL
OFPERM=
®� �V ATION ROBERTA.WOOD.
SUPERVISING MECHANICAL ENG'R
CK. Y.O. CASH
LA.Co 6 0 8 9 2 FEB 4 5 A 1 2.0 0 '1