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' DEPARTMENT OF COUNTY ENGINEER
DIVISION OF BUILDING"AND, SAFETY PERMIT APPLICATI®Id.
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
LOCALITY �.. .l1. ••� t3
FOR APPLICANT TO FILL IN
BUILDING �y NEAREST
ADDRESS ,�," ®� �k �j , t,a+IV�q, CROSS ST. [ (llJ�.a"GrCt�Q \.J
P z a DISTRICT NO. GROUP ZONE 1 N0.
LOCALITY • ../-"srJ��?.JIE..'�..x .�e�;:a ..L. �. rp
NEAREST ;d .• �. �. �.v..p � -,c� _ -----'- . '
CROSS ST, ee°e,°a fsa�.d Ali: "'�_!�.,. �l,e',t�+,.rc.4 A- < ��,R CCEEIVEO 8), 1 Ready for Inspection DATE ISSUED
OWNER 8i-`;��,. � . w�ltaeiha.s4L:>e ei rr• s�,d'il C� �,. r�-� ��
MAIL " INDUSTRIAL
ADDRESS tai •"6 x + s WASTE APPROVAL
r
CITY TEL.N0. INSPECTION RECORD
. ' -
PLUMBER P4 �? a
-ADDRESS
CITY IZ1.41-U &Ir)TEL.•NO.,4 9- 7-J.,
If — rr�� ., ( 'j ' []STATE
LICENSE N0. ,,/S� .ti * ,+ tS s ^'��� n COUNTY J
PERMIT FEES a
z
'IUM9ER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET(TOILET) @ 0.80 $
• BATH TUB @ 0.80rJ
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80 S v
KITCHEN SINK @ 0.80-
LAUNDRY TUB OR TRAY .@ 0.80- �o
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM..._.-.••..-OUTLETS @ 1.00
f WATER HEATER @ 1.00 / /} e)
MISCELLANEOUS. '
• . APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK' 4 1,14i ill.t •a•a
PERMIT $" 1 00 ROUGH PLUMBING
GAS-PIPING
TOTAL FEE ,O t� V�
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THISF APPLI- GAS VENT .f�:�j-!a �fif%/r/.i.• C a- ,
CATION AND STATE THAT THE ABOVE IS CORRECT AND-AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS' j t f_•t_:-�-C:4-•_
REGULATING PLUMBING. PLUMBING FIXTURES _ :5� r -�:•... '
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED-
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY-' - GAS TEST efu` '.a'L`� 4i`r' I,�+'L•1.:_ti x::•�f
AND STATE OF-CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DES. RIBED RESIDSItTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE All _
OF PERMITTEE.•.�r-.
:.-- ..
IZ FINAL
76AG67 DBS-17 1/53 '