HomeMy Public PortalAbout4817 AGNES AVE_Plumbing_9/29/1961_fixtures 76A607-OE81710 60
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUII.DII�iC>�AND�SAFETY DIVISION B
UILDING
JOHN A MBI COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING
FOR APPLICANT TO FILL IN SNUMBER FIXTURE OR ITEM
WATER CLOSE! OWNER �,j
MAID.
BATH TOB ADDRESS
SHOWER CITY TEL NO
LAVATORY CONTRACTOR •
SINK ADDRESS e
DISHWASHER CITY TEL.No,,&
CONTRACT08 S STATE
LAUNDRY TOB BEGISTRATION NO COUNTY
CLOTHES WASHER DISTRICT NO GRAW ZONE P SSED BY
WATER HEATER .� JA
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL �.
INSPECTION RECO o.
u
$1 DOPER ITEM I I
OR FIXTURE $
/0 d0 APPROVALS eAI ( V DATE INSPECTOR SS"IGNNATURE
PERMIT $ 2100 UNDER SLAB WORK 4 fG? +v
TOTAL FEE ROUGH PLUMBING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS PIPING �
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFBGAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE GAS
DESCRIBED RESIDENTIAL PROPS UTILITY CO NOTIFIED �/7
SIGNATURE
OF PERMITTE
FINAL
—mmmmCI ��ALIDATION ROBERT A WOOD
( l000l M O CASH SUPERVISING MECHANICAL ENG R
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