HomeMy Public PortalAbout4949 AGNES AVE_Plumbing_10/16/1951_ EIS 17 10 55 0
DAPPLICATION FOR PLUMBING PERMIT
DBS 17
DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of LOS AngelesBUILDING 9� all
JOHN A LAMBIE COUNTY ENGINEER ADDRESS /
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL INNEAREST �J
CROSS ST
OWNER D
ISTRICT I GROUP I ZONE
I READY FOR INSPECTION
MAIL �j ADDRESSCITY TEL NO w-- STRIAL
EAPPROVAL
PLUMBER Yr. 1INSPECTION R1ECORDd1ADDRESS ! C'l a 1 N In QA..% l I Af c� .L,'1.oJI—CITY (� TEL NOLICENSENO / Qz) 7 :J1
NUMBER TYPE OF FIXT EOR ITEM
WATER CLOSET (TOILET) @ $1 00 $ Q�
'BATH TUB @ $1 00 d C�
SHOWER @ $100
LAVATORY (WASH BASIN) @ $100 61
KITCHEN SINK @ $1 00
DISHWASHER @ $1 00
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER ` @ $1 00
WATER HEATER @ $1 00 J'U
GAS SYSTEM $1 00
APPROVALS
DATE �7 INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ ROUGH PLUMBING
TOTAL FEE 0do GAS PIPING
GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
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 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE
OF PERMITTEE ° FINAL
JOHN A LAMBIE COUNTY ENGINEER ,3ALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
K m 0 CASH
(JJCO 6 5 1 0 11 19AR 2'7 3 500 in