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APPLICATION FOR 'PLUMBING PERMIT
COUNTY OF LOS ANGELES I
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A.D. County ADDRESS 10554 Olive St.
CASSATrLOCALITY
Temple Cit
FOR APPLICANTTO FILL INET. Halifax Road
NUMBER FIXTURE OR ITEM
1 WATER CLOSET OWNER A. Stokes
1 RAW TUB ADDRESS 10550 Olive St
SHOWER crryTemple City TEL.NO.
1 LAVATORY cONTRACTOR Robbins & Wann Plumbing
SINK ADDRESS 8725 Norwalk Blvd.
DISHWASHER cITY Los Nietos 'TEL.NO. OX 21286
CONTRACTOR'S STATE ❑
LAUNDRY TUR REGISTRATION NO. COUNTY ❑
CLOTSF�WASHER DISTRICT N:j GROUP ZONE PR ESSED BY
1 WATER BEATER A -p
GAS SYSTENI INDUSTBIAL
WAST8 APPROVAL
INSPECTION RECORD
'9-1
Alid,<C-- C;��r . jy i I
APPROVALS
7. OR F�URE $ 7.00 DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2Lo ROUGH PLUMBING
TOTAL FEE 9. < GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYHOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED' LOS ANGELES COUNTY AND STATE OF GAS TEST G
CALIFORNIA OR THAT A THE LEGAL OWNE OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED REST E OPERTY.
SIGNATURE
OF PERMIFINAL
TtE
ROBERT A.WOOD.
DF ALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0. CASH
' PD6 7 3 1 U OCT 2 9 5 A 9.0 0