HomeMy Public PortalAbout6029 AGNES AVE_Plumbing__ 78A667 CE#817 4 64
- APPLICATION FOR PL MBING ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY ^ r
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $125 MAIL
BATH TUB 1 25 DRE D oZ
SHOWER 125 CI te
L N 86 M
17
LAVATORY Ips CONTAACTO i
SINS 125 ADDRESS
DISHWASHER 125 CITY TEL NO
LAUNDRY TUB 1 25 CONTRACTOR S STATE [3
REGISTRATION NO COUNTY ❑
CLOTHES WASHER 125 r DISTRICT NO GROUP ZONE PROCES SED BY
WATER HEATER 150 zj
GAS SYSTEM OUTLETS WASTE APPROVAL O
150 INDUSTRIAL a
--/—tOUTLETS OVER S PER SYSTEM 30 INSPECTION RECORD A //1 A 4 V
l I Ild�",.A IO III ✓l A4*1;; W
oZ�r Jl.rin2_ �_ sof' � N
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.41 or
? �� APPROVALSDATE INSPECTOR 5 SIGNATURE
PERLl
$ Z 00 UNDER SLAB WORKROUGH PLUMBING �I✓�dTOTGAS PIPINGIHEREBY ACKNOWLEDGE THAT 1AD THIS APPLICATION GAS VENTAND STATE THAT THE ABOVE IS CND AGREE TO COMPLY I I /WITH ALL COUNTY ORDINANCES E LAWS REGULATING HOT WATER HEATERPLUMBING �¢' _HEREBY CERTIFY THAT 1 AM REGISTERED ANDIOR PLUMBING FIXTURES J v frVLICENSED AS REQUIRED BY LOS AOUNTY AND STATE OFDCALIFORNIA OR THAT 1 AM THE LEER OF AND INTEND TO GAS TEST b 7ARESIDE IN THE ABOVE DESCRIBED RL PROPERTY UTILITY CO NOTIFIED
SIGNATURE I n
OF PERMITTE FINAL
MY I
�/WLIDATION OBERTIWOOD
SUPERVISING
�cK M o cnsH SUPERVISINN G MECHANICAL ENG R
_ M
�vv 0 0 5 3 E,�R 2 3 5 D 250
N
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