HomeMy Public PortalAbout4829AGNES AVE_Plumbing (8) J
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76A667A
CE 817(REV 11/78)
APPLICATION FOR PLUMBING PERMIT
`+COUNTY OF LOS ANGELES BUILDING AND SAFETY L
FORa4PPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS x-829 Vitra�.�e
NUMBER FIXTURE OR ITEM � ® FEE
WATER CLOSET _ 9 00 LOCALITY Tem le Cit Unit-2D
NEAREST
BATH TUB 3 00
F { J CROSS ST v
SHOWER 300 OWNER Fairhaven` Corp.MAIL
.
LAVATORY 9 00 1 ADDRESS +
1 SINK 00 CITY ' TEL NO
DISHWASHER CONTRACTOR Dorsey Plumbing Co.
CLOTHES WASHER ` 00 ADDRESS 800 Pelomeres
+
SWIMMING POOL RECEPTOR +
CITY Le Verne TEL NO 599-0828
LAWN SPRINKLER SYSTEM I I
STATE LIC
WATER HEATER 00 LICENSE NO 312421 421 CLASS B C-36 �
1 GAS SYSTEM OUTLETS 00 APPROVALS " DATE 1 ECTOR S SIGNATURE O
DER SLAB WORK U
UN
OUTLETS OVER �!��` !JC
5 PER SYSTEM ROUGH PLUMBING ,� ��v O
GAS PIPING V
W
GAS VENT , u N
HOT WATER HEATER Z
PLUMBING FIXTURES - A
GAS TEST J0,0-400 - 4—K rw,—
Plan check fee UTILITYCO NOTIFIED V
PLUMBING PERMIT ISSUING FEE$
7 .00
TOTAL FEE 1 43100 FINAL
Plan check applicant
PLAN CHECK VALIDATION'
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Name +� �•
Address
City Tel No ;10
0 a 2 A
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE + a r
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES .4i,� , C+
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION'
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I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS `� - 4300
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE + G 2
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL .. • 0 O O U
PROPERTY ' ,
SIGNATURE + 04,28-80
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OF PERM ITTEE
DISTRICT NO, P OCESSF BY
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INDUSTRIAL
WASTE APPROVAL
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