HomeMy Public PortalAbout4908AGNES AVE_Plumbing (3) 76A607-CE817 10 60
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS tog aaAed
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NE�T
ST
1
NUMBER FIXTURE OR ITEM OWNER
2 WATER CLOSET MAH.
2, BATH TUB ADDA8S8
SHOWER CITY TEL NO d ?9 Z
2 LAVATORY
CONTRACTOR r�
SINS ADDRESS 13/Sr ,
DISHWASHER CITY TEL No 0&4 7 377
RESATOSSTATE
TOB REGISTRATION NO COD n
I CLOTS WASHER DISTRICT^N GR Z NE R D B
WATER HEATER• �� (/
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
I INSPECTION BECORD ,. d
0
O.
N
a
0 $100 PER ITEM n
OR FIRTORE $ /v
,Vv APPROVALS DATE INSPECTOR 881GNATURE
PERMIT $ 2100 UNDER SLAB WORK17/q/cm
TOTAL FEE ROUGH PLUMBING 1 /19D GAS PIPING G ��
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES /7
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF —
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OP THE ABOVE GAS TEST
DESCRIBED RESIDENTIAL OPERTY UTILITY CO NOTIFIED
SIGNATURE •
OF PERMITTE i
FINAL
7KLWATION ROBERTA' WOOD
CM O CASH SUPERVISING MECHANICAL ENG R
Z->91 2 9 �At 5 5 D 1200