HomeMy Public PortalAbout5028 AGNES AVE_Plumbing_4/22/1969_fixtures, water heater, gas system, outlets I .--I a-��7
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APPLICATION FOR PLUMBI G PERMfT
COUNTY OF LOS ANGELES u
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
ADDRESS 028 North Agnes
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
owNER
-361-0 WATER CLOSET 1 50
1 BATH TUB 1 50 / ADDRESS Milton Bade
ESS 20 Birch Croft
1 SHOWER 1 5o "� CITY Arcadia TEL NO
LAVATORY 1150 CONTRACTOR Owen Bros. Plumbing, Inc.
1 SINK 1 50 / —rC ADDRESS 4265 North Baldwin Ave.
1 DISHWASHER 1 50 L) CITY El Monte V711 TEL NO 443-0078
0 STATE LIC
1 CLOTHES WASHER 1 50 ✓ LICENSE NO 231 741 CLASS C 36
SWIMMING POOL RECEPTOR 1 50 DISTRICT N GRpk}P ZO PROCESSED BY
LAWN SPRINKLER SYSTEM 2 00 � C.
1 WATER HEATER 1 50 INDUSTRIAL U
WASTE APPROVAL
1 GAS SYSTEM 5 OUTLETS 1 50 INSPECTION RECORD O
OUTLETS OVER
5 PER SYSTEM 30
W
C-
VL
z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE 9 2 00
TOTAL FEE
APPROVALS IPATE, N ECTOR A S19VATURE
Plan check applicant UNDER SLAB WORK g/47
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City 'Iel No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST Z �s�
PLUMBING
I 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 CC D RESIDENTIAL PROPERTY FINAL
SIGNATURE JACK R ALLEN SUPERVISING-MECHANICAL ENG R
OF PERMITTEE
PERMIT VALIDATAWN M o CASH
PLAN CHECK VALI ATION CK M o C 'SH
� r
P(' 9 5 �0� lien 2 2 5 D 1 3 50—