HomeMy Public PortalAbout4910AGNES AVE_Plumbing (9) 76A667 CE4817 6 65
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING Q/D
JOHN A LAMBIE COUNTY ENGINEER ADDRESS / c5
COLEMAN W JENKINS SUPT OF BUILDING LOCALITY T L�
FOR APPLICANT TO FILL IN CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $125 �e
MAIL
BATH TUB 125 ADDRESS
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINS 125 ADDRESS /U S
DISHWASHER 125 CITY J U TEL NOSTATE LIC
3
LAUNDRY TUB 125 LICENSE NO CLASS T
CLOTHES WASHER 1 25 DISTRICT NO GROUP ZONE I PROCESSED BY
WATER HEATER C/ 1 50 r7r �
GAS SYSTEM—OUTLETS— 150 INDUSTRIALWASTE APPROVAL
OUTLETS OVER S PER SYSTEM 90 INSPECTION RECORD U
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I M PROPERLY REGISTERED AND/OR PLUMBING FIXTURES �I
fill
LICENSED AS REQUIRED BY 1 ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM H LEGAL NER OF AND INTEND TO
RESIDE IN THE ABOVE DES D SI TIAL PROPERT UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL r
/lARLIDATION
CK M O CASH
LAAO 4 8 2 1 SEP 19 5 D 7 50-
r
1