HomeMy Public PortalAbout4833, 4825AGNES AVE_Plumbing (5) T G
76A667A /
CE 817(REV 11/78)
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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 41825 T oT.,o,+ A.,,,.,,,
2 WATER CLOSET 6 OO LOCALITY Qit�E Unit-14A
NEAREST
BATH TUB ( 00 CROSS ST
SHOWER OWNER Fairhaven Corp
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LAVATORY MAIL
2 6 OO ADDRESS
SINK I CITY TEL NO
DISHWASHER CONTRACTOR
Dorsey Plumbing Co
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR O lOID re
CITYVerne TEL NO
LAWN SPRINKLER SYSTEM 599 JATE
LIC
WATER HEATER LICENSE NO 315421 CLASS B 7 C-36 y.
4
GAS SYSTEM OUTLETSAPPROVALS DATE INSPECTOR S SIGNATURE 0
OUTLETS OVER 00 UNDER SLAB WORK S)2-1f— V
OC
5 PER SYSTEM ROUGH PLUMBING — 2^ f 0
GAS PIPING i�p u
% 14 W
GAS VENT C.
HOT WATER HEATER z
PLUMBING FIXTURES n
GAS TEST 1Y
Plan check fee UTILITYCO NOTIFIED U
PLUMBING PERMIT ISSUING FEE$ 7100
TOTAL FEE1 32100 , FINAL
Plan check applicant PLAN CHECK VALIDATION
Name
Address
City Tel No R 0 0 8 4 A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE # O O O O O
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS + O O 3 7
0 0,
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 010 e 3 7 0 0 U
PROPERTY v
SIGNATURE
0428-80
OF PERM ITTE
DISTRICT NO PRpCESSJD BY
INDUSTRIAL j
,WASTE APPROVAL
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