HomeMy Public PortalAbout6053 AGNES AVE_Plumbing__ 76 A 667—C�817 468 ir
• APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS D 3
BUILDING AND SAFETY DIVISIONJOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NF
ARESTS /
CROSS i Lt
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1 50 MAIL
BATH TUB 1 50 ADDRESS Sa !-;p'!
SHOWER 1 50 CITY TEL NO
LAVATORY 1 50 CONTRACTOR O cc--e?
SINK 1 s0 ADDRESS
DISHWASHER 1 s0 CITY TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SKIMMING POOL RECEPTOR 1 50 a
LISTORICT NO GROUPON� PROCESS�EID BY [�
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER 1 50 INDUSTRIAL {{{JJJ
WASTE APPROVAL O
GAS SYSTEM OUTLETS 1 50 INSPEFTION MCORD 101 101
OUTLETS OVER ��
PER SYSTEM 30
vG
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE 8 2 00
'IOTAL FEE O
APPROVALS DATE INSPECTOR SSIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City 1 el No
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION III/Z
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
LRESIDE
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
REQUIRED BY LOS ANGELES COUNTY AND STATE OF
OR THAT I AM THE LEGAL OWNER OF AND INTEND TOHE ABOVE DESCRIBED RESIDENTIAL PROP RTY FINAL
JACK R ALLEN SUPERVISI CHANICAL ENG R
TTE
PERMIT VALIDATIO cK M o CASH
PLAN CHECK VALIDATION CK M o CASH
3 8 autl 2 4 5 D 500-
76A667—CE 8174-68 /
APPLICATION FOR PLUMBG PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEAREST
SS
JOHN A LAMBIE COUNTY ENGINEER ,o
COLEMAN W JENKINS SUPT of BUILDING ITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) ST
NUMBER FIXTURE OR ITEM EACH FEE OWNER � �
WATER CLOSET 1 50 S`
KAIL
BATH TUB 1 50 DRESS 5 ,F—
SHOWER 1 50 CITY TEL NO
LAVATORY 1 50 CONTRACTOR ®C.41,7//`
SINK 1 50 U ADDRESS
DISHWASHER 1 50 CITY TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50
DISTRICT GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2 00 'y—,'e
WATER HEATER 1 50 INDUSTRL0.L 4�
WASTE APPROVAL O
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30 4.e, Ty-dr-13
gg z
Plan check fee 2S% of above See reverse
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address CAS PIPING
GAS VENT
City Tel No HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 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 GAS TEST
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO /01
RESIDE IN THE ABOVE DECCRIBED RESIDENTIAL OPERTY FINAL
SIOF PERM TTEE �'�� JACK R ALLEN SUPERVISING MECHANICAL ENG R
PERMIT VALIDATION CK M o CAS
PLAN CHECK VALIDATION CK M o CASH
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