HomeMy Public PortalAbout4822 AGNES AVE_Plumbing_11/21/1951_17914 fixtures 70AS67 17`39 So It APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP I ZONE PERMIT NO
PLUMBER$ p
V 1"e I O r 1 AMI - � RECE/I�VED BY READY FOR 1 7p(.DATE 1 1(ED
ADDRESS100r4 FIRST IjNSSPECTION
Q (
BUILDING 3/ /Y LJ✓
CITY TEL NO '-1 �o ADDRESS ""T Y
COUNTY ( LOCALITY �"�
LICENSE NO ,5/06 EXPIRES Y
Jf NEAREST
PERMIT FEES CROSS ST ��JJ++,,''J4
"""I"'� !
NUMBF,R TYPE OF FIXTURE OR ITEM FEE OWNER `
MAIL * /_� /
WATER CLOSET (TOILET) @ O 50 S ADDRES V
BATHTUB @ 050 CITY TEL NO
SHOWER Q O 50 I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS
/ LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ O 50 STATE LAWS REGULATING PLU GING
D I CERTIFY THAT 1 ESS THE ABOVE VALID LOS
f LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY SE OR 1 AM THE LEGAL OWNER
OF THE RESIDEN OPERTY DESCRIBED ABOV�
Y GAS SYSTEM OUTLETS Q O 50
SIGNATURE
I WATER HEATER @ O 50 I PERMIT
SLOP SINK @ O 50 INSPECTION RECORD
FLOOR SINK Q O 50
FLOOR DRAIN @ O SOI ///2 7AP
DISHWASHER @ O 50I
/V
DRINKING FOUNTAIN @ O 50
URINAL @ 050
J
HOUSESEWER @ O 50 Q
Z
MISCELLANEOUS (3
O
APPROVALS
DATE INSPECTOR S NAME
ROUGH PLUMBING
GAS PIPING �/► ew, i�-
v
GAS VENT B�
CESSPOOL @ 1 OO I CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1 00 SEWER
PERMIT I 1 00 GAS TEST
UTILITY CO NOTIFIED *.AO /
TOTAL FEE I $ O'
44 FINAL