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7
BS-1.1 �7 10.33' APPLICATION FOR PLUMBING PERMIT 1
1
DMSION OF BUILDING AND SAFETY
- Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS. Q W
CASSATT D.GRIFFIN.SUPT of BUILDING .
LOCALITY tz�f a.
FOR APPLICANT TO I= IN NEAREST d r
CROSS ST.
OWNER 10DIS .NO. I G OUP I ZONE I READY FOR INSPECTION
MAIL T `_�dl Jr'! IIy�J_//j
ADDRESS
INDUSTRIAL I,
CITY TF-L.NO. WASTE APPROVAL
PLUMBER INSPECTION RECORD „
ADDRESS
V 4y C7�i. /N'" 1. / P��✓�. V :1 •x L 'YJI
CITY ) (f TEL.NO. a-,—�—' _ _ ._ c
LICENSE NO/ 5/ O 3q
NUMBER TYPE OF FIXTURE OR ITEM' FEB
WATER CLOSET (TOILET) @ $1.00 5
of y v �'bbb� J ��4
BATH TUB @ '$1.00 l� Y
SHOWER @. $1.00 v
LAVATORY (WASH BASIN) @ $1.00 f
KITCHEN SINK @ $1.00
i
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ 81.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
.17UNDER SLAB WORK ��d�
PERMIT 8 1 .00 ROUGH PLUMBING �•�r 7 P/�
GAS PIPING
TOTAL FEE OQ GAS VENT sy
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS. APPLICATION HOT WATER HEATER G
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY f
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
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 AlTHE LEGAL OWN Ofe-49 ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPS Y.
SIGNATURE w
OF PERMITTEE FINAL
JOHN A.LAMBIE,COUNTY ENGINEER ALIDATION ROBERT A.WOOD. CHIEF PLBG. INSPECTOR
CK R.O. CASH
6 1 SEP 28 3 7.00