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• APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES I Lot # 2
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ann�Ns x'756 Leslie Drm
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY San Gabriel _
FOR APPLICANT TO FILL IN ROSS ST. S
NUMBER FIXTURE OR ITEM EACH FEE
' OWNER J. B. 'Weber Dev, Co, _
WATER CLOSET $1.25 3 75 MAIL
1, BATH TUB 1.25 1 25 ADDRESS 5 26 Temple CitV Blvd.
2 SHOWER 1.25 50 CITY Te le City TEL. NO.
3 LAVATORY 1.25 3 75 CONTRACTOR Valley Plumbing Co,
1 SINK 1.25 1 25 ADDRESS /+./1.2 W. Fleetwood Place
1 DISHWASHER 1.25 1 25 CITY Glendora / TEL. NO. Ed 51293
LAUNDRY TUB 1.25
CONTRACTOR'S
ON NO. 209�h31 COUNTY STATE �❑
1 CLOTHES WASHER 1.25 1 25 DISTRICT NO GROUP ZON PR SSED BY
1 WATER HEATER 1.50 50
l GAS SYSTEM OUTLETS 1.50 50 INDUSTRIAL / a
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 30 INSPECTION RECORD U
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APPXOVA'L'SJ WAY' DATE v INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SL/AB�WORK �o�J°%'r
V..
ROUGH PuLUMBING
TOTAL FEE I 2013U GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 NAVE READ THIS APPLICATION GAS VENT � v
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 24�7
CE -
LINSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �� � ,
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO.. OTIFIED
SIGNATURE - -��`--
OF PERMITTEE
FINAL I r
LIDATION ROBERT WOOD
cK M o CASH SUPERVISING MECHANICAL ENG'R
x;9239 MV 5 5 n 2 0.3 0