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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINE
SUWING AND SAFETY DMSION BUILDRVG
OHN A.LAMI E,County er ADDRESS..6516 N. Oak Ave.
C TT D. GRIFFIN,Sup t of�wlzw LOCALITY
Temple
FOR APPLICANT TO FUl IN DEAREST
CROSS ST.
NUMBER FIxrIIRE OR ITEM OWNER Homer J. Anderson & Sons
WATER CLOSET
rIIs
ADDRESS 12.8781 E. Bess Ave.
l ssowz:R ' cmPark TEL.NO. ED 7-2930 -
LAVATORY CONTRACTOR Plumbing
1 SINS ADDRESS 11900 R. Garvey Ave.
DISHWASHER CITY VT MontpTEL. NO. ou 316gi
LAUNDRY TUR REG RATIoN No. 179568 cooNAx r og
]. CLOTHES WASHER DISTRICT GROUP ZONE. CESSED HY
WATER HEATER s
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD -
G 11.00 PER ITEM _
10 O8 FDCTU88 $ I 10.00 APPROV XO,4R DATE INSPECTOR'S SIGNATURE
PERMIT A 2 00 UNDER S WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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
PLUMBING. HOT WATER HEATER AA TAIL
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED .AND/OR PLUMBING FIXTURES r-B
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS'TEST
CALIFORNIA OR THAT I AM THE LEGA WHER OF THE ABOVE
DESCRIBED BES1 TIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMI FINAL
®P YMMATI6N ROBERT A.WOOD,
cs. M.0. CUR SUPERVISING MECHANICAL ENG'R
0 1.�l 2 DEC 2 3 5 0 1 :2.0 0.