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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER.'
BUILDING AND SAFETY DIVISION BUUDnvG g—j
CASOHN A.LAMBIE. County Enfus ADD8RS3 ! sal Z �d
SA1T D.GRMW.Snp t 0 unzg
LOCALITY
FOR APPLICANT TO I= IN NEAREM
NUMBER FIXTURE OR ITEM
OWNER � •��
WATER CLOSET NAIL-
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SATE TUB ADDRESS
SHOWER CITY i.Pl . TEL.NO.
LAVATORY CONTBACTOR� c
snas ADDRESS "I 7 >L
DISHWASHER CITY TEL.NO. 3 3 S
CONTRACTOR'SSTATE
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LAIINDRY TUB REGISTRATION NO.'I �� J / `.�'^ COUNTY ❑
CLOTHES WASSER DISTRICT D. GROUP N PROCESSED B
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
@ Rico PER ITEQ4
OR r1Or7� DATE I
NSPECTOR'S SIGNATURE
J UNDER SIA3 WORK ,
PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE Q GAS PIPING
'D
ACKNOWLEDGE THAT I HAVE READ THIS A PLICATION GAS.VENT ID-2 /�, .�,IIn Af
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER V4
WITH. ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES `
i 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 AN THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED •�"� "j r-f�C^✓
DESCRIBED RESID ENTI PROPERTY.e o� �
8 FPERMITIEE— f FINAL 7-9"sl
®p' VALIDATION ROBERT A.WOOD.
SUPERVISING MECHANICAL ENG'R
CK. N.0. CASH
11100 9 4 8-- JUL 2 p •5 A - 9.00