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APPLICAPION FOR PLUMBING fkRMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION - BUILDING ADDRESS -�
]OHN A. LANffifE, County En ear
CASSATT D. GRIFFIN.Sup t of Building LOCALITY _
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER G D
WATER CLOSET N7AS
BATH TUB ADDRESS.
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR vaileY um ingCo.
SINE
ADDRESS442 l eetwood Pl .
DISHWASHER CITY en ora TEL. NO. Ed 5 112
CONTRACTOR'S y tj STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY El
/ CLOTHES WASHER DISTRICT NO. GROUPON/E PRyoCESSED-BBy
WATER HEATER v —/
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
All
APPROVALS
.UU PER ITEM
O @ OR F CIURE S 0-0
DATE IN RECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT S1 2100 ROUGH PLUMBING 3.7- .p J
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH 5 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 i IS
LICENSED AS REQUIRED BY LOS AN ELES COUNTY AND STATE OF
CALIFORNIA DR THAT 1 THE EGAL OWNER OF THE A DYE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL ROPERT .
SIGNATURE '
OF PERMITT FINAL a
®rROBERT A.WOOD.
ALIDATION SUP ERVI SING MECHANICAL ENG'R
rc. H.a. CASH
L.A.Co 6 0 91 FEB 4 5 A 1 2.0 0