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APPLICATION ,FOR '.PLUMBING—PERMIT �
COUNTY OF LOS. ANGELES
DEPARTMENT OF.COUNTY ENGII?IEFEB
BUILf�TGI_AND SAFETY-DMSION _ IAIMDMG" ,s
JClR A. MBIE. COUNTY ENGINEER ADDaESS
WILLIAM A. JENSEN, SUPT OF BUILDING .,LOCALITY
FOR APPLICANT TO PILI. IlQ Cas.
NUMBER FLVrURE OR ITEM 0Wmm
WATER CLOSET' 9 ggAjr.
ADDRESS .
Sm TUB 9 440
crrY TEL NO.
s$OWER• -
1CONTUCTORAIARWW.
LAVATORY i ADDRESS e ` 6
SISIB14f �
_DMEWARHEa =CITY ip.L"'r e"40 / !' .TEL.No,op
B��BGanog NO.
LAUNDRY U � �7 COUNTYrAT4
CLOnm WASHER DISTRICT NO. GROJJP I PR SELL BY
WATER / �—
GAS WE= INDUSTRIAL
WASTE APPROVAL
INSPECTIO REC,O$D/ _ O
f
� $I.iB FeR ITEM d � f 'J �( "' _ � •���' Vit.-"'�1
OR FIXTURE F-/' !APPROVALS DATE NSPECTOR'981GNATURE
PERMIT o s 2 00 • UNDER SLAB WORK /%
ROUGH PLUMBI G:� L�
TOTAL FEE f
•GAS.PIPING.')-4 16.1 bill -
I HEREBY ACKNOWLEDGE THAT I HAVE READ-THIS:APPLICATION
AND STATE THAT THE ABOVE 18 CORRECT AND A¢REE TO,COMPLY GAS VENT
WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING HOT.WATER HEATER_:
PLUMBING. - - ` q
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES . .Ft
LICENSED AS REQUIRED BY LOS ANGELES COUNTY"AND STATE OF GAS F
TEST t /' . i (J/
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE f / -
DESCRIBED RESIDENTIAL PROPERTY. •UTILITY CO.NOTIFIED �/!• t/ I
SIGNATURE jI
OF PERMITTE -FINAL
VALIDATION ROBERT A!WQOD
cK M:O.' CASH SUPERVISING'MECHANICAL ENG'R- cm
`
LACo 5 2 2 5 OCT 5 5 .A. .8 6.2 5 N.
tW 'E817"IG-59• •
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDINGFOR APPLICANT TO FII.L IN CRONUMBER FIXTURE OR ITEM
RWATER CLOSET BATH TUB 4p . TEL. NO.
SHOWER
LAVATORYCONTRACTOR l \ L
•I .� 47
SINK P ADDRESS 7 e -
DISHWASHER CITY ( � �> r//�/ TEL. NO-,,j ,
CONTRACTOR'S STATE p-'
LAUNDRY TUB REGISTRATION NO. / .1 y' COUNTY ❑
CLOTHES WASHER --4DISTRICT NO. GRO P I P
'RQqESSED BY
WATER HEATER
GAS SYSTEM :1 INDUSTRIAL
WASTE APPROVAL }
INSPECTION RECORD D_
v0
� U
,V
h
fir? w
a
Lo
_ Z_
_ 3 G3
Ip $1.00 PER ITEM $ I ��
OR FIXTURE APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE 41
ROUGH PLUMBING
GAS PIPING -
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLU riB ING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES '
LICENSE DL REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE GAS TEST /
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE ���' _ - � -
OF PERMITTEEFINAL lir
VALIDATION ROBERT A. WOOD
CK
M.0. CASH SUPERVISING MECHANICAL ENG'R
L"5225% OCT 5 5 A 86.25 a