HomeMy Public PortalAbout5935 1/2 AGNES AVE_Plumbing__ 76A667 (CE 817) 1/74
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO ADDRESS S 3 S �2 ( C
HARVEY T BRANDT, COUNTY ENGINEER
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST r
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET
200 OWNER
MAIL 14GA19-.y
BATH TUB 2 00 ADDRESS
SHOWER CITY 77ZInlotIE eL 1-Y TEL NO
LAVATORY 200 CONTRACTOR L(f J
SINK 200 ADDRESS ag oaj:10 o
DISHWASHER 200 CITY �S .OrzN TEL NO 1 Q
CLOTHES WASHER 2 00 STATE (�L' LIC
LICENSE NO C3 ' ! CLAS S"7
SWIMMING POOL RECEPTOR 2 00
DICT NO JGJUP� NE ESSED BY
LAWN SPRINKLER SYSTEM 200AOL
ti
WATER HEATER 2 00 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2 00 INSPECTION RECORD a
OUTLETS OVER C:)
5 PER SYSTEM 30 V
O
H-
U
W
N
Plan check fee See Reverse ti
PLUMBING PERMIT ISSUING FEE S 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant
UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF ,
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DES IBED RESIDENTIAL PROPERTY FINAL
Q�
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION M o cnsH
PLAN CHECK VALIDATION CK M o CASH
5 4 1 JLhq 15 D 4 7 5 At-
76A667 CE#817 9/63
APPLICATION FOR PLUMBING PEROT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS ��7- 77
WILLIAM A JENSEN SUPT OF BUILDING LOCALITY
�L
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER 0.C G
/ WATER CLOSET $125 MAIL
BATH TUB 125 _ ADDRESS a P S (yi/LOZ �L G v
SHOWER 125 / CITY L &A TEL NO -' Z�
LAVATORY 125 CONTRACTOR , L C-0
SINE 125 ADDRESS (/,p 4v
DISHWASHER 125 CITY TEL NO
LAUNDRY TUB 1 25 CONTRACTOR S STATE [I
REGISTRATION NO V 0 COUNTY ❑
CLOTHES WASHER 125 DISTRICT NO GROUP I ZONE P,,1tOCESSED BY
WATER HEATER 1 50 Q ,Z ^ (/LJ
GAS SYSTEM OUTLETS 150 0 INDUSTRIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD U
51A-RAa •d , MP > � o
W
D.
Z
APPROVALS DATE INSPECTOR S SI G_NATURE
PERMIT S 2 00 UNDER SLAB WORK yro/A ��- ";�l
ROUGH PLUMBING I (,p�h1s,
2S ® 47 sal
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY /
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER f
PLUMBING
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 OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROP Y UTILITY CO NOTIFIED
SIGNATURE V r�
OF PERMITTEE
FINAL
(�ALIDATION ROBERT A'WOOD M o CASH SUPERVISING MECHANICAL ENG R
L&O3782SEP 15 5 D 1125~ v