HomeMy Public PortalAbout4910AGNES AVE_Plumbing (12) 76A667 CE617 12/59 TEL CITY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGUME
BUILDIl G AND,SAFETYMSION ADD R sS /D !TU
JOHNLAMBI COUWILLIAM A JENSEN SUPT OF BUILDING77
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEMOWNEB orWATER CLOSET MAIL
BATH� ADDRESS
CITY SHOWERLAVATORYCONTRACTOR SINS ADDRESS /yoz
DISHWASHER CITY li® 6CONTRACTORS � r STATELAUNDRY TUB REGISTRATION NO CQ COIINTY ❑
CLOTHES WASHER EZASTE
TRICT NO I GR UP ZONE ESSED BY
WATER HEATER
GAS SYSTEM RIAL
APPROVAL
INSPECTION RECORD
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$ or APPROVALS { PATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE QO ROUGH PLUMBING �c 7�E
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS PIPING
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 fe
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES Q _SCI r
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE oil
DESCRIBED RESIDENTIAL PPERTY UTILITY CO NOTIFIED
SIGNATURE c
OF PERMITTE
FINAL r
VALIDATION ROBERT A WOOD
B 0 CASH SUPERVISING MECHANICAL ENG R
n 9 6 2 3 ID 144 1 5 5 D 1100