HomeMy Public PortalAbout4827AGNES AVE_Plumbing (3) 76A667A r
CE 817(REV 11/78) ; 1 • '
APPLICATION (FOR PLUMBING 'PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY , r
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDiNG
ADDRESS 482 I7
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NUMBER FIXTURE OR ITEM r ® FEE'
LOCALITY `
WATER CLOSET -
NEAREST —
BATH TUBCROSS ST Aga
SHOWER 3
00 OWNER Fairhaven Corp.
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LAVATORY MAILADDRESS
SINK3 00 CITY TEL IVO
DISHWASHER CONTRACTOR Dorsey Plumbing CO.
CLOTHES WASHER 300 ADDRESS ,
SWIMMING POOL RECEPTOR OO Z m r
CITY VerneTEL NO
LAWN SPRINKLER SYSTEM
599
STATE LIC
WATER HEATER00 LICENSE NO 315421 CLASS B, C-36
1 GAS SYSTEM OUTLETS 3
00 APPROVALS DATE INSPECTOR S SIGNATURE O
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING J `O
' GAS PIPING Y W
GAS VENT N
HOT WATER HEATER 'Z
,
PLUMBING FIXTURES
GAS TEST J-a qqb�-
Plan check fee ` UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ 00 n
TOTAL FEE 44 00 FINAL
PLAN CHECK VALIDATION
Plan check applicant
Name f
Address
City Tel No 0 7 7 A
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE 1 , , 1
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES r
AND STATE LAWS REGULATING PLUMBING a 0 PERMIT VALIDATION # • • • J,
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS /, Z3OO
REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE r L r�y • 4
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY + •r• * 43Q03
SIGNATURE h p Q Q 0/1° +
OF PERM ITTE U Nr v 8
DISTRICT NO JPROCESJED BY `
INDUSTRIAL
WASTE APPROVAL