HomeMy Public PortalAbout4835AGNES AVE_Plumbing 76A667-CE817-8-58
APPLICATION FOR PLUMBING PERMIT
ERMI
co1
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING -+
JJOHN A. LAMBIE, County Engineer ADDRESS
SSATT D. GRIFFIN,Supt of Building LOCALITY
.:
FOR APPLICANT TO FILL IN NEAREST p
est
NUMBER FIXTURE OR ITEM CROSS ST.
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY L. NO.
SHOWER
LAVATORY CONTRACTOR d?!
SINS ADDRESS S a `,
DISHWASHER CITY 406 1064 TEL67. NO. 73 7 V-
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. C-3613 -3 �/,v COUNTY
CLOTHES WASHER DISTRt� GR,OU)� ZONE PROCESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
&fid INSPECTION RECORD
APPROVALS
08 FIXTURER E $
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING
TOTAL FEE 00 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP (C
'P ATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE r UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
y) h
SIGNATURE • p �C'd o FINAL
OF PERMITTEE
®p ROBERT A.WOOD.
VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0. A H
LAL';o 2 X 4 3 ' SE," 1 4 5 A 4.00