HomeMy Public PortalAbout6313 AGNES AVE_Plumbing__ O 8.8 17 RSM SETS I ae APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ���
COUNTY OF LOS ANGELES
Wm .1 FOX CHIEF ENGINEER
NATUREMBING
OF INSTALLATION DISTRICT
NO GRO l O E PERMIT O
ROUGH FIXTURES COMPLETE / 3/Z�
HEATER CESSPOOL RECEIVED BY READY FOR DATE SUED
SEPTIC TANK f� /AS ELLANEOUS FIRST INSPECTION /
M C / V �
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
E NAME Lyman F. Merry ADDRESS 71(JAN. Agnes
m ADDRESS 825 E. Broadway Temple City
g LOCALITY
REST
J CITY San Gabriel TEL�'NO 1-0385 CNRoas
ST Tnngrlowm
COUNTY 4686 EXPIRES 6/30/49
CERT NoC NAME George Pink
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 1830 Allen Court
3 ADDRESS
NORTH O By
CITY Pc c O TEL No 1–
IAM THE LEGAL P SSESSOR OF THE ABOVE LOB
ANGELES COUNTY CER ICATE OF QII IFICATION
rr��PL MB�t
I AM THE LEGAL OER OF THE PROPERTY DES IHED
ABOVE
OWNER
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK a
z_
ATH TUB FURNACE D
1 R
MOWER DISHWASHER D
1
VATORY REFRIGERATOR
r
1 KITCHEN BINK WATER SOFTENER
-FLOOR BINK -------SAND TRAP
SLOP BINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
1 WATER CLOSET DRINKING FOUNTAIN DATE INSPEC
TOR
SINAMQ _
—._WATER HEATER DENTALLAVATORY ROUGH PLUMBING
-METER—GAS L=ODA FOUNTAIN
OUTL GAS PIPING
t „
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES 8 SEPTIC TANK
CESSPOOL SEPTIC TANK SEWER II
$
TOTAL FEE 4 50 UTILITY CO NOTIFIED + 1
t 0-17/' - f ��A�p�/�S-U
1 FINALi ��
76A667 17 5-49 ® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
���� '
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO.
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS
BUILDING
CITY TEL. NO. ADDRESS
COUNTY LOCALITY
LICENSE NO, EXPIRES
NEAREST
PERMIT FEES cRoss sr.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) Q 0.50 s ADDRESS
BATH TUB Q 0.50 CITY TEL. NO.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ 0.50 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 I ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS Q 0.50 SIGNATURE OF
WATER HEATER @ 0.50 PERMITTEE
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50 f
DISHWASHER @ 0.50I R
DRINKING FOUNTAIN @ 0.50
URINAL Q 0.501r A J
HOUSE SEWER @ 0.50 Q
Z
MISCELLANEOUS (�
0
I
I
I
I
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL Q 1.001 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT . . I 1.00 GAS TEST
UTILITY CO. NOTIFIED
I TOTAL FEE $ - I
FINAL