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APPLICATION FOR . PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING�AND-S AND-SAFETY DNMSEON BUILDIER NG
10125-'Land' er
JOHN WILLIAM A. JENSEN, SUPT OF BUILDING -
LOCALITY Terri le' City
FOR APPLICANT TO FILL IN NEST
CROSS ST.
NUMBER FIXTURE OR'ITEM. - OWNER -J J B Weber.C Ons trii t i O_n-CO•
2 WATER CLOSETy
].
BATHTUB
'ADDRESS
CITY TEL..NO.
SHOWER
2 LAVATORY CONTRACTOR ®I7 f n g CO; .
1 S� ADDRESS .442 Fleetwood pi . ,
DISHWASHER CITY ell ora- TEL_. NO. Ed 5-12
1 LAUNDRY TUB RCEGISTRATION NO.160a47 COUNNTrl
TYY ❑
1 CLOTHES WASHER DISTRICT NO., C3ROUP NE P SEED BY
WATER HEATER (� .
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL - • �.
INSPECTIONRECORD CL
0
O
@ $1.00 PER ITEM
10 OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 bO UNDER SLAB WORK-
.� ROUGH PLUMBING
TOTAL FEE u ^� ' /
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT I - '
WITH ALL COUNTY ORDINANCES'AND STATE-LAWS,REGULATING
PLUMBING. HOT WATER HEATER ► ���' �' �
' a'^
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
CEDp ,A
LINSED AS REQUIRED BY LOS ANGELES COUNTY'AND STATE OF •GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER,OF-THE ABOVE y _
DESCRIBED RESIDENTIAL PRo ERTY. UTILITY CO. NOTIFIED 7�t�
v
SIGNATURE � � ��• '
OF PERMITT -
ATION ROBERT.A.,WOOD
CK: M.o. CASH SUPERVISINd MECHANICAL ENG'R
LAT: .� OCT 1 `�, ,C :T