HomeMy Public PortalAbout4907AGNES AVE_Plumbing (2) I 76A667-CE817-11-57
APPLICATION FOR PLUMBING PERMIT 4,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER IN
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County Engineer ADDRESS
CASSATT D. GRIFFIN, Sup't of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM CROSS ST.
WATER CLOSET OWNER
MAIL
ADDRESS
BATH TUB
SHOWER CITY. TEL. NO.
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. J COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP + ZONE READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
'D—:
APPROVALS
dal $1.00 PER ITEM DATE INSPECTOR'S SI NATURE
OR FIXTURE $
UNDER SL•*B WORK - S" x0'a_
PERMIT $ '�, 00 ROUGH PLUMBING ^_)` r-.qe.y. �i►,res
TOTAL FEE { GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 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
BLICENSEDASCERTIFY REQU REQUAT I IRED LOSMANGELESLCOUNTYSTED AND STATE OFR GAS TEST 2-yJ' !4'Z
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED -
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE FINAL - 1L►4rr (-�-/ROBERTA.WOOD.
®F VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.O. CASK