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DOS-17 IE-B4 APPLICATION FOR PLUMBING- PERMIT
DOS-17 7
DMSION OF BUWING AND SAFETY
Department of County Engineer
County of Las Angeles BUILDING iy7�
WM.J. FOX. COUNTY ENGINEER ADDRESS UU//
CASSATT D.GRIFFIN.SUP'T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER 9. d'L / DISTRICT. GROUP �o I READY FOR INSPECTION
MAIL I � �
ADDRESS
INDUSTRIAL o
CITY TELL.N WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS rt�1 'r L. �j7 l_/ 0 +ev- �n7 tU/de
CITY TEL. NO. ) 611y.
y. — Z� A
LICENSE NO.
9 & t v
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK -
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER n
C 7,2451460
y i
TOTAL NO. a 0.80 : O APPROVALS
DATE INSPECTOR'S SIGNATURE
GAS SYSTEM OUTLETS ® 1.00 D
r 17
WATER HEATER (LD 1.00 � m® UNDER SLAB WORK
ROUGH PLUMBING
PERMIT 3 1 00 GAS PIPING
TOTAL FEE 9 510 GAS VENT -7— /A
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER A
AND•STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - V
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR _ GAS TEST II-�I• �Q � ,.
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE UTILITY CO.NOTIFIED
CALIFORNIA OR THAT ! AM THE LEGAL OWNER F THE ABOVEVE
DESCRIBED RESIDEWA PROPi
SIGNATUREg(�(/J � �.•
OF PERMITTEE FINAL - 7- `v /er f ,It mj
WILLIAM J. FOX,COUNTY ENGINEER VALIDATION
ACD 7 2 8 1 AUG 3 0 9 e4 0
BY
76AGG7-CE#817 12.64 City of Temple City P 5383
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS9705Boole
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST tt 1.1CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25MAIL Robert Powitsky
BATH TUB 1.25 ADDRESS Sqma
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 CONTRACTOR General Installation Co.
SINS 1.25 ADDRESS 6558 West Blvd.
DISHWASHER 1.25 CITY Los Angeles TEL. NO. PL 3-2541
LAUNDRY TUB 1.25 CONTRACTOR'S REGISTRATION NO. C-36 151839 787c ST
ATE
UNTY
CLOTHES WASHER 1.25 DISTRINO. R P ZONE =SS
BY
WATER HEATER 1.50 _
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL d
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD v
Ready for Inspection Now
0
C3
W
O.
IT
H
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEEO GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 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 LEGAL OWNER OF,AND INTEND TO
RESIDE IN.THE ABOVE DESCRIBED REBID AOP Y. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
ALIDATION ROBERT A.WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
LhL;o 4 1 1 4 0 AUG 12 5 D 3.50-
Cq