HomeMy Public PortalAbout4833, 4825AGNES AVE_Plumbing (8) T L.
76A667A % _
CE 817(REV 11/78)
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
T,(�_____'_" _'___
NUMBER FIXTURE OR ITEM @ FEE ADDRESS 48
WATER CLOSET LOCALITY Temple Cit Unitz,7C
6 00 NEAREST !I
BATH TUB 3 OO CROSS ST ^Aew
SHOWER 300 OWNER Fairbeven Corp
MAIL
2 LAVATORY 6 00 ADDRESS
1 SINK 3 00 CITY TEL NO
DISHWASHER CONTRACTOR Dorsey Plumbing Co
CLOTHES WASHER ( ADDRESS OOpajoMereS
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM
CITY Ila Verne TEL N0599— 8
1 STATE LIC
WATER HEATER 00 LICENSE NO"1'"315421 C ASS B I C-36
GAS SYSTEM OUTLETS
APPROVALS DATE INSPECTOR S SIGNATURE Q
00 V
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING $ w.► O
GAS PIPING _yam„ W
GAS VENT 17"'
N
HOT WATER HEATER Z
PLUMBING FIXTURES
GAS TEST '
Plan check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ OO
TOTAL FEE37 OO FINAL
Plan check applicant ,
PLAN CHECK VALIDATION
Name
Address
City Tel No ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES r�
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION O O a / R
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # O O O O 4 5
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
PROPERTY 2o - 3700
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0 0 0 '3TOOU vT NO PR CESSE BY 0428r8O
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