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'APP.ILICA`T'I®N F OR . PL_UMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 5832" .M.uscatel Ave.
WILLIAM A.JENSEN, SUPT OF BUILDING
LOCALITY Temple Cit count
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. Hermosa. Dr.
NUMBER FIXTURE OR ITEM EACH FEE
1 WATER CLOSET s1.as MAIL OWNER Nu 11
1 BATH TUB 1.25 ADDRESS
CITY TEL. NO.
SHOWER 1.25..
1 LAVATORY 1.25 • 5 'CONTRACTOR Jose' h Cadilli
SINK 1.25 ADDRESS 7821 'E. Garvey Ave.
DISHWASHER 1.25 CITE•San G a b r i e l TEL. NCZ O--5 3 9
CONTRACTOR'S 1 3 493 5 0 3 6 STATE
LAUNDRY TUB I.25 REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 1 -25 DISTRICT GROUP Z NE CESSED BY
WATER HEATER 1.50
1 GAS SYSTEM OUTLETS 1.50 1 O WASTE AP ROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD u
F
APPROVALS DATE . INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE • O- GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
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/011PLUMBING FIXTURES
A LI
CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF, GAS TEST 'r
CALIFORNIA OR THAT I 'AM E LEGAL OWNER OFINTEND TO
RESIDE IN,THE ABOVE DES IBED RESIDE N•ALP - ERT UTILITY CO.NOTIFIED
SIGNATURE '
OF PERMITTEE �� -rs
FINAL FD
VALIDATION ROBERT A. WOOD.
• CK.
M.0. CASH SUPERVISING MECHANICAL ENG•R
Bio093 .9G OCT 2 5. A 8.5 0, v