HomeMy Public PortalAbout5803 AGNES AVE_Plumbing__ 76A667A(GEA17B) 11/76
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE
ADDRESS $O N. Agnes Ave
WATER CLOSET d D LOCALITY Temple City
NEAREST )`� 4,1-7 C�J
BATH TUB CROSS ST
SHOWER V OWNER Rosemead Construction
LAVATORY U MAIL
ADDRESS 527 S. Atlantic
SINK CITY Monterey Park TEL NO
4,43_9,513
DISHWASHER CONTRACTOR Owen Bros. Plumbing, Inc.
CLOTHES WASHER ADDRESS 4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR CITY El Monte TEL NO 443-0078
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER .Aq LICENSE NO 231 740 CLASS C36'20
GAS SYSTEM
tik OUTLETS DISTRICT NO GROUPZQjJ� PR HSSED BY
CJ JCS
OUTLETS OVER
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL 0
INSPECTION RECORD u
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Plan check fee
PLUMBING PERMIT ISSUING FEE$ (J
<4 TOTAL FEE
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Plan check applicant
APPROVALS I DATE INSPECTOR S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
i
City T Tel No GAS PIPING c�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT,IyAM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LLEGALOWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
TY + UTILITY CO NOTIFIED
TUREERMITTEE FINAL
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION G I o CASH
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