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DEPARTMENT OF COUNTY ENGINEER
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING �s q pyo
WILLIAM J. FOX/ COUNTY ENGINEER ;;ADDRESS �•� � o / i
FOR APPLICANT TO FILL III
LOCAJNEAR ITY
BUILDING /-1 ^ NEAREST y-
7 0�6 CROSS ST, �I �LI— CI
ADDRESS �•
DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY
NEAREST
CROSS ST. "l J�f'� C�'r ,�I RECEIVED BY Reudy for Inspection �y DATE ISSU. D
OWNER s — A e 96N Ill.-t+">J
MAIL /A d_•._- INDUSTRIAL
ADDRESS (J,J•GWV WASTE APPROVAL
CITY TEL.NO'
.�f INSPECTION RECORD
PLUMBER fx
ADDRESS
CITY /y TEL.NO. WSTATE
C e E{OUNTY
LICENSE N0. Q
PERMIT FEES _Z
•IUMSER TYPE OF FIXTURE OR ITEM FEE LII
WATER CLOSET(TOILET) 0 0.80 S
I p
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) 0.80
KITCHEN SINK 0.80
LAUNDRY TUB OR TRAY 0.80
SLOP SINK 0.80
FLOOR SINK 01! 0.80
FLOOR DRAIN OD 0.80
DISHWASHER
DRINKING FOUNTAIN 0 0.80
URINAL- OD 0.80
GAS SYSTEM............-OUTLETS OD IAO
_D WATER HEATER Of 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE'
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE lob . GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- 6A8 VENT rr
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER HEATER =104, ` 6
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALICORNI -a AT 1 AM THE LEGAL OWN-
ER OF THE ABOVE S D E$IDENTIAL ROPERTY. UTILITY CO.NOTIFIED
SIGNATUREju
OF PERMITTE �... -�f".`s •�,�"=s ..... FINAL 11
70A067 '011317 r.,,