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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUMDING AND SAFETY DMSION BUILDING
JOHN A.LAMBIE.County ED ''neer ADDRESS
Cl D. GRIFFIN.Supt of Sulu LOCALITY
FOR APPLICANT TO FILL IN CEASES T.
NUMBER FIXTURE OR ITEM
OWNER �
WATER CLOSET
RATH TUR A DRESS Ji[Jr
SHOWER CITY TEL NO. C'
LAVATORY CONTRACTOR
Sag ADDRESS
DISHWASHER CITY TEL NO.
LAUNDRY TUR CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTRI '. O. GR ZONE READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
MPEC77ON RECORD
APPROVALS
am PER ITEM DATE INSPECTOR'S SIGNATURE
OR FISTURE $ I UNDER SLAB WORK
PERMIT $ O ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION'.',
GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS. REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AA THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL ERTY. oil
I
$IGNATURE
OIC PERMITTE FINAL
ROBERT A.WOOD.
®p ALIDATION ' SUPERVISING MECHANICALENG'R
CK. N.O. CASH
LC03 7 9 0MAR20 5 A 3.00