HomeMy Public PortalAbout4922AGNES AVE_Plumbing (2) 78A6Ei;CE��>i S�3 � i
' APPLICATIO F R PLUMB G PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE County. En ear ADDRESS .f
CASSATT D GRIFFIN Sup t of Bmldmg LOCALITY
FOR APPLICANT TO FILL IN NEAREST c
CROSS ST
NUMBER FIXTURE OR ITEM
L OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
` CITY TEL NO
` SHOWER
LAVATORY
CONTRACTOR c
SINK ADDRESS f
DISHWASHER CITY TEL NO (/ 6p Lf 6,3
LAUNDRY TUB —CONCTOR
NO 3 6 6 �p tp DL�/ STATE
d COUNTY
CLOTHES WASHER DISTROICT,{l0 GR UP ZONE PR ESSED BY
WATER HEATER Qpp��
L4
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL / <<
INSPECTION RECORD
i,
c. .
DD PER ITEM
O I /0 1
O8 FDfTUAE $ APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE / ROUGH PLUMBING .10 cam►
GAS PIPING V N
1 HEREBY ACKNOWLEDGE THAT I 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 AN PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
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 PROPE UTILITY CO NOTIFIED
SIGNATURE
OF PERM ITTEE--j0j-C--(612l
FINAL
OF ATION ROBERT A WOOD
CK ® 0 CASH SUPERVISING MECHANICAL ENG R '
L4 4 6 51501 hU, 4 5 D i ? 0C) �r