HomeMy Public PortalAbout4831AGNES AVE_Plumbing (7) 76AG67A
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APPLICATION FOR PLUMBING PERMIT ,
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS 4831 Lowed A++rrrti a
LOCALITY9Co.2 WATER CLOSET 00
NEAREST
1 BATH TUB 00 CROSS ST
SHOWER OWNER FaCorbaven
LAVATORY MAIL
ADDRESS
SINK CITY TEL NO
r DISHWASHER CONTRACTOR DorseyPlumbing
CLOTHES WASHER 3 00 ADDRESS
800 Palomares
SWIMMINGLPOOL RECEPTOR
LAWN SPRINKLER SYSTEM
CITYLa Verne TEL NO LC-36
82
'
TATE LIC
1 WATER HEATER 00 LI ENSE N0315421 CLASS B,
a
GAS SYSTEM OUTLETS APPROVALS DATE INSPE TOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING —L
GAS PIPING J C
GAS VENT 'b V
HOT WATER HEATER 0
PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITY CO NOTIFIED k'' ► Z
PLUMBING PERMIT ISSUING FEE$ 1 , ?Ion
TOTAL FEE 1 32 100FINAL r3�
Plan check applicant PLAN CHECK VALIDATION
Name
Address
City , Tel No , >
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE ' ;20092A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION # • • • • • 5
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I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS e� Z
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE Z 6 6 3 7 00
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY 6 6 * 37 005
1
SIGNATURE 04.28-80 4.2 8—8 0
OF PE RMITTEE U c U
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DISTRICT NOd r P �P�ED f �
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INDUSTRIAL S
WASTE APPROVAL �+ i