HomeMy Public PortalAbout4942 AGNES AVE_Plumbing_6/17/1968_water heater, shower, lavatory 76A667 CE#817 10 67
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�► APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING A�� r
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 1y T
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST
CROSS ST � J
NUMBER FIXTURE OR ITEM EACH FEE
Ka?�
WATER CLOSET 1 50 t S U OWNER 61-1
MAIL
BATH TUB 1 50 ADDRESS Z- /� At-e S
SHOWER 1 50l s^Q CIiY L� TEL NO
LAVATORY1 50 CONTRACTOR U
iA
SINK 1 50 ADDRESS 2 I
DISHWASHER 1 50 CITY � N b, TEL NO a
CLOTHES WASHER 1 50 STATE `ajLc-:j j 7_3 CLASS
LIC
LICENSE NO 7fn
SWIMMING POOL RECEPTOR 1 50 DISTRICT NO GROUP ZONE P CESSED BY
LAWN SPRINKLER SYSTEM 2 00 5-,0 D -f _' Ck, O_
O
WATER HEATER 1 50
INDUSTRIAL V
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD CDU
OUTLETS OVER A - - w
5 PER SYSTEM 30 / .+� / (� D_
Z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE QO APPROVALS DATE INSPYCTOR S SIGNATURE
Plan check applic-int UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL C'
SIGNATURE JACK R ALLEN SUPERVISING MECHANICAL ENG R
OF PERMITTEE
PERMIT VALIDATION(�D M O CASH
PLAN CHECK VALIDATION CK M 0 CASH
LAuo 5081 JL4117 5 D 800N d
t