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78A 667-CE#817 10-62
APPLICATION FOR -PLUM ING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER _
BUILDING AND SAFETY DIVISION AD 62*North Ilcnva
JOHN A. LAM BIE. COUNTY ENGINEER t
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY le (�'.
FOR APPLICANT TO FILty
L IN77 NEAREST
CROSS ST.
[N7UMBER FIXTURE OR ITEM EACH FEE 'OWNER -0.J.Ste& Weber Const GOWATER CLOSET $1.25 MAIL y�/ No,
BATH TUB 1.25 ADDRESS 5926 le C Blv4 '-
H/ CITY Twple C TEL. NO.
SHOWER 1.25'
LAVATORY 1.25
CONTRACTOR VSLUe Ppb Co.
SINK 1.25 ADDRESS t4A2 Wo Fleetwood PZ
DISHWASHER 1.25 CITY Glendora, - TEL. NO. =,'5-1293
LAUNDRY TUB. 1.25 REGISTRATION ION NO. 209431 COUNTY CTOR'S STATE p,
CLOTHES WASHER 1.25 DISTRICT NO GROUP ZONE PROC SEP BY
WATER HEATER 1.50, 7"
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL d
WASTE _APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD u
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4 IA
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` APPROVALS ,'DATE• q INSPECTORS SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING ••�.p�/
TOTAL FEE 6 GAS PIPING J
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT'THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORDINANCES AND STATE LAWS,REGULATING HOT WATER HEATER -
PLUMBING _ -
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES J
LICENSED AS REQUIRED BY-LOS ANGELES COUNTY-AND STATE OF
I GAS TEST
CALIFORNIA OR•THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO OC Wc/ 1+•+•"Z
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIEDP
SIGNATURE w 7a ,cI y�/ --a�•I.f�I
OF PERMITTEE FINAL
ALIDATION ROBERT A WOOD
cK m o CASH SUPERVISING MECHANICAL ENG R
L s'93.9�1.0 AUG-27 5 D
16'2 5"N .