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TSAfiE,
1' APPLICATION FOR PLUMBING PERMIT 1
Dss- DIVISION OF BUILDING AND SAFETY
Deportment of County Engiaeen
County of Los ABgeles BUILDING �+
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
L7
CASSATT D. GRIFFIN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILLJINNEAREST
sCROSS ST.
OWNER c.` -(_ DISTRICT NO. GROUP ZONE p¢nox Fox IxSveciion
MAIL fn? /ADDRESSINDUSTRIAL
CITY TEL. NO. WASTEAPPROVAL
PLUMBER ��Ge(�/ yINSPECTION RECORD
ADDRESS 4A
CITY TEL. NiyO '��V"' �K Ems✓ �C7�
LICENSE NO. XO/ !Pie�r S'C//fi�r .�p /� ,�•�
NUMBER TYPE OF FIXTURE OR ITEM FEE V('��IE•_, F —�"'�R
Lj
WATER CLOSET (TOILET) @ 91.00 $
BATH TUB @ 91.00
ROWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00
AKITCHEN SINK @ $1.00
DISHWASHER @
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.0074-
d
GAS SYSTEM
@ $1.00
APPROVALS
ATE I INSPE NATURE
UNDERSLABWORK QQ
ROUGH PLUMBING 6 1 G-v
PERMIT f 00
GAS PIPING
TOTAL FEE GAS VENT d
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP (CATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT ANo AGREE TO COMPLY "'(
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING_
�f
PLUMBING. `/ t
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST `/ Cl
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF i
CALIFORNIA OR THAT AM THE EGAL OWNER OF 111E ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENT[ PROPE � '/
SIGNATURE
OF PERMITT L FINAL
JOHN A. LAMBIE. COUNTY ENGINEER PON ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
K. Y.Y. CASH
..1v0 O G .�. y �n J'J- 27 5 A
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