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DEPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
BUILDING FOR APPLICAN TO FILL I� LOCALITY��L
2 NEAREST
ADDRESS h/L �� CROSS ST. l Y1A�S
DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY � A-
6 7(0-3
CROSS ST, tu;t re- ..S ECEIVED BY Ready for Inspection D TE• IISSSU D
OWNER
MAIL INDUSTRIAL `
ADDRESS WASTE APPROVAL
CITY �1 TEL.NO.- j�/� INSPECTION RECORD
PLUMBER
� ` �, N !
-/r � Z.0 �.A �'
a �a� /ndP' ��
ADDRESS aJ'�/
CITY TEL.NO;2— b D f I
p� ❑STATE
LICENSE NO. .S"!� r ❑COUNT(' J
PERMIT FEES a
z
NUMBER TYPE OF FIXTURE OR ITEM FEE Q
WATER CLOSET(TOILET) @ 0.80 ; 70
/ O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.60 r
LAUNDRY TUB OR TRAY @ 0.80
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SLOPSINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM_ ........OUTLETS @ 1.00
WATER HEATER @ 1.00 --/—goo
MISCELLANEOUS
APPROVALS
�9,0(TTE INSPECTOR'S SIGNATURE
UNDER SLAB WORK �s�/�//1,. ��•9
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE �� GAS PIPING !/ted ",�A li
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES �!
STERED
AND/OR LICENSED CERTIFY
AS REQUIRED BYLOSEANGELES RLY GICOUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL'PROPERTY.
UTILITY CO.NOTIFIED /J
SIGNATURE % /OF PERMITTEE....
FINAL ^�
76A667 DBS 17 1/53