HomeMy Public PortalAbout4827 AGNES AVE_Plumbing_5/9/1980 76A667A _r' C -
�CE 817(REV 11/78)
> APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY y
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS' ' 4822S
NUMBER FIXTURE OR ITEM ° @ FEE
WATER CLOSET , 00 LOCALITY T n —
NEAREST �
BATH TUB" 00 CROSS ST
'SHOWER OWNER Falrbeven Corp;
LAVATORY ADDRESS "
SINK 300 CITY TEL NO
s
DISHWASHER , CONTRACTOR Dorsey Plumbing Co.
800 ,
CLOTHES WASHER ADDRESS Pelomares
SWIMMING POOL RECEPTOR
CITY La Vernp `TEL NO599
_
LAWN SPRINKLER SYSTEM JATELIC
WATER HEATER LICENSE NO 31542 CLASS B 1; Ci-36 a
GAS SYSTEM OUTLETS APPROVALS DATE .INSPECTOR S SIGNATURE Q
UNDER SLAB WORK �o m V
OUTLETS OVER \ OC
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING �� V
W
GAS VENT * IL
N
HOT WATER HEATER Z
PLUMBING FIXTURES
GAS TEST Y
LPIanck fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ 00 t5
TOTAL FEE 400 FINAL
Plan check applicant PLAN CHECK VALIDATION
Nome
i
Address _
City Tel No F ~�0 0"7.87A
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION'AND STATE + r ' ' #
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES v
AND STATE LAWS,REGULATING PLUMBING PERMIT VALIDATION '2•• •40 0
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 4 3 0 0
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL ii,9
60
PROPERTY
• 0428-80
SIGNATURE ,
OF PERM ITTE
DISTRICT NO OCES
INDUSTRIAL j
WASTE APPROVAL `
t
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