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"2 APPLICATION FOR PLUMBIN PERMIT,
OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY 'DMSION c
- BUUIILaINLDIN
JOHN A. LAMBIE. COUNTY ENGINEER
7��, WILLIAM A.JENSEN, SUPT OF BUILDING LOCALS
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. L
NUMBER FIXTURE OR ITEM EACH FEE D`
OWNER
WATER CLOSET $1.25 MAIL
7,; BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
'Z LAVATORY 1.25 CONTRACTOR Alert Pl.umbin & Hawting
7j SINS 1.25 ADDRESS 13933: Sa.- Crenshaw Blvd.
DISHWASHER 1.25 CITY Hawthorne TEL. NCO.S 936:91
CONTRAIS19361.7 .0-3.6 STATE ❑
LAUNDRY TUB 1.25 REGISTRATION NC COUNTY ❑
CLOTHES WASHER 1.25DISTRICT NQ GROUP ZONE P ESSED BY
Z WATER HEATER 1.50 (M7 ( _
Zi GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 90 INSPECTION RECORD
i A 6f ®
LL. prttpw
9-6-4 Z BFT L�riy$wZ-1,�f��nro
APPROVALS DATE INSPECT 'S SIGN TURE
PERMIT . 2 00 UNDER SLAB WORK
ROUGH PLUMBING 1
TOTAL FEE. 1 7., GA$PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT I
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. f 1
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN.THE ABOVE DESCRIBED LENTIAL PROPERTY. UTILITY.CO.NOTI KIED
SIGNATURE I / ��.%f l�ti AI' if/Iy!
OF PERMITTEE FINAL ' W-I , ulx/-
ALMATION OBERT A.WOOD
CK. M.O. CASHUPERVISING,MECHANICAL.ENG'R
33 .73AUG 22 5 D 20.50run
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