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APPLICATION FOR PLUMBING PERMIT 9
COUNTY OF LOS ANGELES
DEPAHTD(ENT OF COUNTY ENGINEER /
BUILDING�ANDDSAFETY DMSION
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FOR APPLICANT TO FILL IN NFJIBF
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NUMBER FIXTURE OR ITEM OWNER
WATER CLOSE! MAIL
RATS TUB ADDRFM
SHOWERCRY TEL NO.
LAVATORY CONTRACTOR
SUM ADDRESS
DffiiWABRER CITY NO.
CONTRACTOR 3
LRUNDRT TUB REGISTRATION NO COUNTY
CIATHPB WAS DISTRICTNO GROUP ON6 ED BY
WATER EMRTER S
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WASTE APPROVAL '
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APPROVALS PAM IN! 6CTOR!lIGNATURE
PERMIT 9 E 00 UNDER SLAB WORK A
TOTAL FEE �jp ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAY! READ THIS APPLICATION
AND STATS THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT '
WITH ALL COUNTY ORDINANCES AND !TATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERN ARD/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGE ES COUNTY AND !TATE OF GAS TEST 1 A
CALIFORNIA OR THAT 1 AM THE L OWNER OF THE ABOVE
DESCRIBED RESIDENT] PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE
FINAL J
Or ONA MATION ROBERT A WOOD.
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APPLI ATION FORPLUMBINGPERMIT
CO OF LO ANnEE�,�fy.E,� 3
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WILLIAM A JENBHN, Buri or BUILDIND LOOALTTT
FOR APMCMT TO FILL HQ REMIEST
NUMBER FIXTURE OR ITEM CROSS
BY
OWNER
WATER CLOSET KAM
BATH TUB ADDRESS
SHOWER CIT! TEL NO
LAVATORY CONTRACTOR _
am ADDRESS
DISHWASHER CRT ` NO _
CONTRACTOR 8 NOrTATELAUNDRY TUB REGISTRATION ROCLOTBPS WASH88 DI6TRICT NOGROUP Z E P
WATER HEATER
GAB Imm.lBTAl.
WASTE APPROVAL
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G
U
N
W '
A 00 PES ITIn! _
H PDi'IUBE S APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ E 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
ARD STATE THAT THE ABOVE IS CORRECT AND AGREE TO CORPLT
WITH ALL COUNTY ORDINANCES AND STATE LAWS RROULATINO
PLUMBING HOT WATER HEATER
I 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 LE OWNER OF TIR ABOVE
DESCRIBED RESIDENTI PROPERTY
UTILITY CO NOTIFIED
SIGNATURE J
OF PERMI INAL
Or �AMATMN ROBERT A WOOD
R p CAN SUPERVISING MECHANICAL ENG R
LAC09853 $ DEC15 5 D 3.00