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]EABfi] -CERBI] 9/APPLICATION FOR UMBING (PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 2 LaRosa
WILLIAM A. JENSEN, SUPT OF BUILDING Temple Cit
LOCALITY
FOR APPLICANT TO FILL IN NEARESTOSS r
NUMBER FIXTURE OR ITEM EACH FEE
1 WATER CLOSET $1.zs l 2 ° R Charles Dickens
MAIL
BATHTUB 1.25 ADDRESS 9621 E. LaRosa Drive
CITY Temple City, TEL. No-AT 618 4
]- SHOWER 1.25 1 2
1 LAVATORY 1352 CONTRACTOR Dan ' s Plumbing Service
SINK 135 ADDRESS 1620 Indiana Avenue
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DISHWASHER 1.25 CITY Paramount TEL. No. 634-1291
LAUNDRY TUB 1.25 CONTRACTOR'S
flAT ON NO. 188734 COUNTY STATE TE p
CLOTHES WASHER 135 DISTRICT NO. GRO LE NE P�i ESSED BY
WATER HEATER 1.50 /
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL a
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM .00 INSPECTION.RECORD A u
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APPROVALS )A
T
E INSPECTOR S SIGNIJUR_E
PERMIT 5 2 00 UNDER SLAB WORK
C ROUGH PLUMBING y,���f U
TOTAL FEE 7 25 GAS PIPING !�I
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
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1 MEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
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LICENSED AREQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR TMAT I AM TME EGAL OWNER OF,AND D TO
RESIDE IN, THE ABOVE DEEC B RESIDENTIAL PROP TILITY CO. NOTIFIED
SIGNATURE
OF PERMIT -
.FINAL D[.V I'�JSRI�It
LIDATTON ROBERT G MECHANICAL
cK. M�.o, cnsH SUPERVISING MECHANICAL IENG R
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