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6AS67 APPLICATION- FOR PLUMBING PERMIT .1
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DMSION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Aagele8 ' BUILDING
JOHN A:L.AMBIE, COUNTY ENGINEER ADDRESS U
CASSATT D,GRIFFINS SUPT OF BUILDING
LOCALITY p Y.
FOR APPLICANT TO.FILL.•IN NEARCROSS sT.
OWNER //JE • DISTRICT GROUP I ZQ; READY FOR INSPECTION
MAIL
ADDRESS LO1. !/L �/•/
CITYAL.F. CIT TEL.NO. WASTE APPRINDUSTRIALOVAL I '
PLUMBER INSPECTION RECORD
ADDRESS
CITY TEL.NO.
LICENSE NO. _ le ay
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $ OG �Z• `x.1'&1 � yj! Jr/1LfaLYI PLC 7r .c.
BATH TUB @ $1.00•• -
SHOWER @ $1.00 00 � ,_ J � / •�<lrl �yl"7`" !•f�/
LAVATORY (WASH BASIN) @ $1.00 00 /
KITCHEN SINK @ $1.00 nye
DISHWASHER @' $1.00 _ Il Ab6J?
LAUNDRY TUB OR TRAY @ $1.00.
CLOTHES WASHER @ •$1'.00 7_/ /
WATER HEATER @ $1.00 >` "' -5�' /y � jy y rUXFLod R Fr�
GAS SYSTEM @ $1.00 �)�l h% i` ni�j:':1 'r 1•� {lfiia?'Pr:
Nn /l ISP::dlrl), PRePARE
APPROVALS C}
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK p
PERMIT $ 1 00 ROUGH PLUMBING /' �,{/;a •
O0 ..GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. IPLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE_LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIA PROPER
SIGNATURE
OF PERMITTEE FINAL
OHN A.LAMBIE.COUNTY ENGINEER VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CB. R.O. CASH
(AW
2595-M FEB 7 3 4.0 0