HomeMy Public PortalAbout5921 AGNES AVE_Plumbing__ 76A667 CE817 2/59 TEMPILE C2TY
x APPLICATION FOR PLUMPING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT A AND
COUNTY ENGINEER
BUILDING pAND SAFETY ?BnSION BUILDING /
JOHN A L MBIE COUNTY NGINEER ADDRESS
WILLIAM A JENSEN SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST e
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL NO
LAVATORY CONTRACTOR
SINS ADDRESS
DISHWASHER CITY TEL NO
CONTRACTOR S STATE ❑
LAUNDRY TUB REGISTRATION NO COUNTY ❑
CLOTHES WASHER DISTRIIC'T�O GR P TE/ R ES BY
WATER HEATER (J{�
GAS SYSTEM INDUSTRIAL
WAqTE APPROVAL
INSPECTION RECORD
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@ $100 PER ITEM
/ OR FIXTURE $ /A APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING-H , 6
VVVVVV GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER F T ABOVE
DESCRIBED RESIDENTIA OPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMIT TE - FINAL
OF VALIDATION ROBERT A WOOD
CK m 0 cesH SUPERVISING MECHANICAL ENG R
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76A667 CE617 ti2/59 TEMPLE COTY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AFETYIVISION BUILDING n
JOHN A L MBI COUNTY NGINEER ADDRESS 9 �C/ Al, &e2r -/I d-
WILLIAM A JENSEN SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEARESTOSS v S
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER TEL NO A.'r *7-3 6
i
CONTRACTOR Oe
LAVATORY
SINK ADDRESS
DISHWASHER CITY TEL NO
CONTRACTOR S STATE ❑
LAUNDRY TUB REGISTRATION NO COUNTY ❑
CLOTHES WASHER DISTRICT NO GROUP /ZONE PR CESSED BY
WATER HEATER ,-ra f " 1
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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W
W
$1 00 PER ITEM
/ OR FDtTUBE $ o APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE I I4� ROUGH PLUMBING
GAS PIPING
t HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF VIE ABOVE
DESCRIBED RESIDENTIAL- ROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERM[TTE FINAL
OF VALIDATIOosERT A WOOD
CK Y p �R UPERVISING MECHANICAL ENG R
[r-!n7665 'InY '26 5 D 300
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7ene87 n e EO 0) APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES 1
WILLIAM J FOX CHIEF ENGINEER
F,qR.,4PPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO
3
PLUMBER r 9� // � � __ �1�BY FIRST INSPECTION DAT ISSUED
ADDRESS ei{„� ® ((({ ' IP
��,p.' - I .(—/CBUILDING
CITY ��-1 TEL V<V ADDRESS
L CENSY O '�36 LOCALITY � 3, ,�.,.
EXPIRES C�
NEAREST _ f
PERMIT FEES CROSS ST Q�J
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Al
MAIL / (�
WATER CLOSET (TOILET) @ O 50 $ ADDRESS ` �f
BATH TUB Q O 501 I r
CITY TEL NO
SHOWER Q O 501 t HE Y ACKNOW GE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) Q O 50 I APPLICA N AND STAJ THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING
KITCHEN SINK Q O 50 I I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q O 50 ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
OF THE RESIDENTIA PROPERTY DESCRIBED BOVE
GAS SYSTEM OUTLETS Q O 50 N�
SIGNATURE OF W/•�. 0
WATER HEATER @ O 50 IPERMITTEE ff�Vllll
SLOP SINK @ O Sol I
INSPECTION RECORD
FLOOR SINK @ O 50
FLOOR DRAIN Q O SO
DISHWASHER Q O SO
DRINKING FOUNTAIN Q O 50 I
URINAL @ O SO I .I
HOUSESEWER Q O 50I I Q
Z
MISCELLANEOUS
O
I�
I�
APPROVALS
DATE INSPECTORS NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1 00 I CESSPOOL
SEPTIC TANK I SEPTIC TANK
i DRAIN ( ) PIT ( ) @ 1 00 SEWER
PERMIT 1 00 GAS TEST
TOTAL FEE $
UTILITY CO NOTIFIED
/ Q
FINAL