HomeMy Public PortalAbout4833, 4825AGNES AVE_Plumbing (9) a r •-
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CE 817(REV 11/78) I ! a x •^
if AAPPLICATION FOR PLUMBING PERMIT r
COUNTY OF LOS ANGELES BUILDING AND SAFETY A
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING _,z
NUMBER FIXTURE OR ITEM ® FEE ADDRESS 4'8 3 ''vxau� o
2 WATER CLOSETt r3 r 00 LOCALITY Temple t —
V NEAREST
� I BATH TUB 00 CROSS ST
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1 SHOWER 3 00 OWNER FairnavenTorp
2 LAVATORY ADDRESS t r no MAIL r i t
(SINK r CITY { TEL NO
DISHWASHER CONTRACTOR Dorsey Plumbing Co
1 CLOTHES WASHER 300 ADDRESS
800 pqjOMarj
SWIMMING POOL RECEPTOR b es
CITY La Verne TEL N0599-0828
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LAWN SPRINKLER SYSTEM a STATE 315421 r LIC ; B I C-36
1 WATER HEATER a 00 LICENSE NO CLASS
1 APPROVALS DATE INSPECTOR S SIGNATURE 0
GAS SYSTEM OUTLETS p r� f
OUTLETS OVER iia UNDER SLAB WORK w2 &o r ,i _^ RC
5 PER SYSTEM ROUGH PLUMBING 7-2-J-%3 �.V�m O
~ GAS PIPING % V o u
w$ Z GAS VENT CL
r HOT WATER HEATER f Z
PLUMBING FIXTURES
K I GAS TEST . o-+ g }
Plan check fee UTILITYCO NOTIFIED V a
PLUMBING PERMIT ISSUING FEE$ 7 00
TOTAL FEE3f f 00 FINAL „t a,/_fj+
Plan check applicant
PLAN CHECK VALIDATION
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Name
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Address,
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City Tel No F _
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 4 a m o o a 8 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING ! PERMIT VALIDATION # -4- 5
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS 4 1' i
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE a 4^ 2o - 3700
y
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL E A
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PROPERTY r ,' 3 7 0 0 5
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SIGNATURE r 1 1 0428-80
OF PE RM ITTE E
A————DISTRICT NO P CESSEDI Y + �r
INDUSTRIAL; Y b t
WASTE APPROVAL 1
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