HomeMy Public PortalAbout4843AGNES AVE_Plumbing 76A667 CE817 8 58
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUn8� "
JOHN A LAMBIE County Engmeer
CASSATT D GRIFFIN Sup t of Huild3ng LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM -
OWNER
WATER CLOSET
BATH TUB ADDRESS
SHOWER CITY NO
LAVATORY CONTRACTOR L,
SINK ADDRESS 3/
DISHWASHER CITY PO4 TEL NO b+d 7 3 7 9 Z
LAUNDRY TUBCONTRACTORS STATE
AEGISTRATIONaNO C-36 133q/0 COUNTYi.
CLOTHES WASHER DISTZjQTmVO GR0UP� ZONE OCESSE "
a, WATER HEATER 3 ,1� l ; r K ,
t GAS SYSTEM nmUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
7-
A4;sf+—
` APPROVALS `
�OB u $ I OD" DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT S 2100 ROUGH PLUMBING
TOTAL FEE Q GAS PIPING
tAHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND'STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
,,WITH hALL COUNTY ORDINANCES AND STATE LAWS REGULATINGGi
PLUMBING PLUMBING FIXTURES
I I AHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED`AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,TH OVE UTILITY CO NOTIFIED
DES
eCRIIBED RESIDENTIAL PROPERTY
SIGNATIURE
�OF,�ERMITATE FINAL
MEN®p ROBERT A WOOD
VALIDATION —
UPERVISING MECHANICAL ENG R
CK d 0 CASH
r
LAC0 2 5 4 2 rn SEP 14 5 A 400