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DEPARTMENT OF COUNTY ENGINEER B '
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENQINEER ADDRESS
FOR APPLICANT TO FILL IN LOCALITYNEARES
G�
BUILDING / E CROSS ST 6-- I MInnA `P Y
ADDRESS I
DISTRICT NO. GROUP ZON PERMIT NOO.0
LOCALITY / .✓I�L+�T!..�sf d Pd +�_1F�' f/"`9 `/[_7
NEAREST
CROSS ST. to�1�./'f</I/9A17/a�¢d � �5•+� }'—IjI}ECEIVED BY Ready for Inspection DATE ISSUED
OWNER 1_.SR iI4� Id9� X f�A.�a' �`F 1 ' a ea 7731 Z,0
MAIL ( ` 41 INDUSTRIAL
ADDRESSy/ .yrp..pL+It�. r WASTE APPROVAL
CITY TEL. O. ii ` �,3 INSPECTION RECORD
N" !/
PLUMBER
ADDRESS
CITY�{1_ _� TEL.NO.
[]STATE
LICENSE NO. M COUNTY
J
PERMIT FEES a
z
`I UM 13 ER TYPE OF FIXTURE OR ITEM FEE UI
WATER CLOSET(TOILET) @ 0.80 $ CO-0 Ir
O
BATH TUB. @ 080 Q
',4"2 SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80 pV
KITCHEN SINK @ 0 80 a
1 LAUNDRY TUB OR TRAY @ 0 80 �O
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM..._ ----.OUTLETS @ 1.00 D�
,I` WATER HEATER @ 1 00
MISCELLANEOUS
APPROVALS
Abe p,..L DATE/ INSPECTOR'S SIGNATURE
UNDER SLAB WORK"--
PERMIT
OR PERMIT $ I 1 00 ROUGH PLUMBING
TOTAL FEE 7 1
GAS PIPING � '�
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES �)
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED /
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TESTAND OFI
OR THAT I AM THE LEGAL
ER OFTTHE A`BOVELIFORNIA DESCRIBED RESIDENTIAL PROP RTY.OWN UTILITY CO.NOTIFIED n I /
SIGNATURE
OF PER MI TT E� i_I .. _ d1y9�-------.._...-------
FINAL
76A667 6BS-17 1/53 ��