HomeMy Public PortalAbout4910AGNES AVE_Plumbing (3) 78A867 CE#'817 5 61 1 /
r APPLICATION FOR PLUMBING' PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 1
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` JOHN A LAMBIE COUNTY ENGINEER �Qa-
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WILLIAM A JENSEN Sup IT OF BUILDING
FOR APPLICANT TO FML IN
NUMBER FIXTURE OR ITEM
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WATER CLOSE! MAIL
BATH TUB
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LAVATORY CONTRACTOR
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DISHWASHER CITY TEL NO
CONTRACTLAUNDRY TOB REGISTRATION NO CODS TY
CLOTHES WASHER DISTRICT NO G OU ZONE ED BY
WATER HEATER !�( Off.
GAS SYSTEM INDUSTffiAL V
WASTE APPROVAL
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OR FD:TURE $ APPROVALS DATE INSPECTOR 8 SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING f
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
D I
ANSTATE THAT THE ABOVE 18 CORRECT AND AGRI% TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER '
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES t
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PE Er FINAL A., 3 `'
VALIDATION-4-,ROBERT A WOOD
CK M O CggH SUPERVISING MECHANICAL ENG R
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