HomeMy Public PortalAbout5937 AGNES AVE_Plumbing__ 76A667 CE0817 9/63
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING F
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 7 Al Ai
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY � � C
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSES 31 25
— MAIL
BATH TUB 125 ADDRESS Cil (iD
SHOWER 125 CITY L, TEL NO Q 9
LAVATORY 125 Z d CONTRACTOR L e 0
SINK 125 ADDRESS
DISHWASHER 1 25 CITY 91 TEL NO ;'
LAUNDRY TUB 125 CONTRACTORS STATE
REGISTRATION NO Q COUNTY
CLOTHES WASHER 12S rDISTRICT NO GROUP ZONE PROCESSED BY
WATER HEATER 150O LC f11/Lr
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INDUSTRIAL a.
GAS SYSTEM Jr150 OUTLETS WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD V
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In
Z
APPROVALS DATE INSPECTOR 5 SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK 7lR�Jdl(«iy�yi
O ROUGH PLUMBING YY
YC'n'A.P
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TOTAL FEE 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 HOT WATER HEATER
PLUMBING44
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 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE AB DESCRIBED RESIDENTIAL PROP Y UTILITY CO NOTIFIEDIA
"
SIGNATURE
OF PERMITT FINAL
ALIDATION ROBERT AIWOOD yr
CK M O CASH SUPERVISING MECHANICAL EJG R
LI,o31783- SEP15 5D 1500- Q
/ D B S 17 2SM BETS 12 44 r ' y
VVVV PLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES o
Wm J FOX CHIEF ENGINEER PLUMBING ` �~
NATURE OF INSTALLATION DISTRICT NO GROUP I ZONE PERMIT NO
ROUGH FIXTURES COMPLETE
HEATER CESSPOOL —I SEPTIC TANK _1000' RECEIVED BY READY FOR DATE ISSUED
v- FIRST INSPECTION q
GAS MISCELLANEOUS
APPLI ANT FILL HEAVILY OUTLINED PORTION ONLY
E NAME ADDRESS
ADDRESS3 NEARESTCJ� I LOCALITY
4 CITY , TEL No/// ��` CROSS 8T
COUNTY
CERT No EXPIRES � NAME �Y
LOCATION OF SEPTIC TANS, OR CESSPOOL, z MAIL /��
3
ADDRESS
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NORTH 0 CITYT TEL No O o 'j
I AM THE LEGAL POSSESSOR OF THE ABOVE L08
ANGELES COUNTY CERTIFICATE OF QUALIFICATION
PLUMBER
I AM THE LEGAL OWNER THE PERTY DESCRIi6D
" AHOY6 /l
4
oWNSR
t CORRECTIONS
a
SOUTH d
DESCRIPTION OF WORK
+ATH TUB FURNACE
O
ROWER DISHWASHER 1
4
LAVATORY REFRIGERATOR f
KITCHEN SINK WATER SOFTENER
FLOOR SINK RAND TRAP
—SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
/ WATER CLOSET DRINKING FOUNTAIN DATE � INSPECTORS NAME
WATER HEATER DENTAL LAVATORY t ROUGH PLUMBING i ✓ n A
L
METER GAS QODA FOUNTAIN GAS PIPING IJ Iv
OUTL 1
\ ; GAS VENT I
CESSPOOL I I
\ TOTAL NUMBER OF FIXTURES SEPTIC TANK
� l
CESSPOOL SEPTIC TANK / J SEWER
` 8 "'o UTILITY CO NOTIFIED I
�S`� I J
TOTAL FEE
it FINAL
76A667 17 25M SETS 7 413 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
DISTRICT O P Z13NEP
FOR APPLICANT TO FILL IN
PLUMBER "SOL-/L �.rLl/1~1 r RECEI,V� READ FOR _ DATE ISSUED
FIRST INSPECTION t
ADDRESSv p ..vnPyl�c� �1 .1�R ! .c�J S
CITY �' � (��/ TEL No JOB _
ADDRESS
COUNTY
LICENSE NO Y EXPIRES LOCALITY
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEAREST n�
ANGELES COUNTY LICENSE CROSS ST n
OWNER / y
�u MAIL
PLUMBER ADDRESS
PERMIT FEC IS $1 OO FOR THE FIRST FIXTURE OR CITY TEL No
ITEM LISTED BELOW PLUS SOC FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP
ITEM FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE
$1 00 MINIMUM FEE FOR ANY PERMIT $1 00 EACH
GAS SYSTEM IS A SEPARATE ITEM
OWNER
NUMBER TYPE OF FIXTURE OR ITEM
WATER CLOSET (TOILET) CORRECTIONS
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
LAUNDRY TUB OR TRAY
GAS SYSTEM OUTLETS
WATER HEATER
SLOP SINK J
Q
FLOOR SINK _Z
FLOOR DRAIN _O
Ir
DISHWASHER 13
O
DRINKING FOUNTAIN
URINAL
MISCELLANEOUS
APPROVALS
DATE INSPECTORS NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL
SEPTIC TANK DRAIN ( ) PIT ( ) $ SEPTIC TANK
CESSPOOL $ SEWER
HOUSE SEWER $ GAS TEST I
TOTAL FEE /1
UTILITY CO NOTIFIED ^ �!/ zp
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