HomeMy Public PortalAbout4829 AGNES AVE_Plumbing_5/12/1980 ' 76A667A p '° '1` �. .` 'it -777
CE 817(REV 11%78) .°n•+ ' 'I •L r " • °ts` 1 t
" %APPL"ICATIONKF'OR`PLUMBING "PERMIT, n;
s
°COUNTY OF LOS ANGELES' ". >~ BUILDING AND SAFETY. "� b
• "
• ' r� ' `Y, M r � ,, s a
e a s FOR APPLICANT TO FILL IN(PRINT OR TYPE( , v BUILDING
ADDRESS °
NUMBER_ ` „F,IXTURE OR ITEM @ FEE LOCALITY I.
"
emI:eQl
,sWTERCLOSET QQ Ty TUT n1t-1E3 r > .
NEAREST
r BATH TUB r r x "3 QQ CROSS ST + •_ r
'I SHOWER_'
, OWNER Falrbr ev n Corp
0 MAIL
LAVATOY QQ ADDRESS
SINK +3S
r y
I "
QQ CITY + t -" . J TEL''NO
DISHWASHER, CONTRACTOR"DOrsey `Plumbing Co.
n
CLOTHES WASHER 3
1 � . '• 3 QQ , ADDRESS °
SWIMMING POOL RECEPTOR b S00'Paloma Ares - _-
' :ITY Le Verne �� Sp TEL N0599-0828'. . "
LAWN SPRINKLER SYSTEMSTATE'
LI
WATER HEATER _ ' ,• ?� QQ LIC NSE NO" lI 42'1 y+ CLASS B,'
0-36
GAS SYSTEM ' , OUTLETS QQrROUGH
OVALS DATE 1 CTOR 5 SIGNATURE V
r OUTLETS OVER , WORK "�= Z ~ Q�
5 PER SYSTEM MBING` u
GASJVENT + ..y
ar M" ' • • _ ' HOT WATER HEATER ,. rJ Z
` s
PLUMBING FIXTURES
GAS TEST '
a t` a 4 ° /,a'�
Plan check fee "" t ' UTILITY-CO NOTIFIED `
PLUMBING PERMIT ISSUING FEE$ " "j QQ
TOTAL FEE r 43, 00 FINAL
Plan check applicant ' y PLAN yCHECK"VALIDATION
f, �
Name J, R + ' ", _ It % a F ti
i / J
Address
4
City, , ` Tel No r
I'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION-AND STATE '° • t
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES - / °" A ` '40 0`^3 a'y'
1
AND STATE LAWS REGULATING PLUMBING" �„ , ,, PERMIT VALIDATION ' " + • °I` '' r
r r #"eb •,• • 5 '
* 1 HEREBY CERTIFY THAT I AMrPROPERLY REGISTERED AND/OR LICENSED AS t 1� °j
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA°OR THAT I AM THE 1 "' Y °, • 30b,
LEGAL OWNER.,OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 2 • 4,f
PROPERTY `� + a " • _ A • .;� . 1 •`
r h r $ X r k+s4i •r• • r t
4a0,02
�
SIGNATURE r J r
OF PERMITTEE _ T'' ` a x '., It r `" `��( Q ,
r 14,
DISTRICT NO ,' P CESfiE B - ` mai r °' -%} '
s
7WDUSTRIAL r ,'' Y` r - ' 1 A
PPROVAL,
Y