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APPLICAPION FOR PLUMBING *RMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING /
]OHN A. LAMBIE. County
En AD"
ADDRESS �6 .rO = L/=
CASSATT D. GRIFFIN, Supt of Building LOCALITY
L
FOR APPLICANT TO FDS IN CROSS
NUMBER FIXTURE OR ITEM /
/✓
WATOWNER GJ U
ER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR Valley Plumbing Co.
surR
ADDRESS 442 W. Fleetwood Pl .
DISHWASHER
CITY en ora TEL. NO. Ed 5-12c i
CONTRACTOR'S 160847 STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY
/ CLOTHES WASHER DISTRICT NO. GROUP I ZONE I PR ESSED BY /
WATER HEATER S
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
a EM
O8 PER
EXTURE S DATE^ INSP TOR'S SIGNATURE
y UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE pop GAS PIPING
1 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
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 AM T LEGAL OWNER OF THE ABOVE UTILITY CO.NOTI FIED
DESCRIBED RESIDENTI PROP Y.
r
SIGNATURE ,j,(7 �� FINAL
OF PERMI
ROSERTA.WOOD.
®r. ALIDATION SUPERVISING MECHANICAL ENG'R
CK. R.0. CASH
1N�fl6092� Fr 4 5 A 12.00