HomeMy Public PortalAbout4926AGNES AVE_Plumbing (5) I
70AIS
DBS+�7 APPLICATION FOR PLUMBING PERMIT
IVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of Los Angeles BUILDING �? / �� EI
JOHN A LAMBIE COUNTY ENGINEER ADDRESS `(�7 �/
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY E L
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OWNER 61 111AM . it 046441 DISTRIC NO GROUP I ZONE I READY FOR INSPECTION
MAIL
ADDRESS 9
+� INDUSTRIAL
CITY C Le er TEL NO ` WASTEAPPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $100 $ D0
BATH TUB @ $100 U
SHOWER @ $100
LAVATORY (WASH BASIN) @ $100 DV
KITCHEN SINK @ $100
DISHWASHER @ $1 00
LAUNDRY TUB OR TRAY @ $100
CLOTHES WASHER I @ $100
WATER HEATER @ $100
GAS SYSTEM @ $100
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING 'a O W
GAS PIPING v
TOTAL FEE 111 00 GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER 0 THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE
OF PERMITTEE FINAL
JOHN A LAMBIE COUNTY ENGINEER VALIDATIONROBERT AKWOOD CHIEF PLBG INSPECTOR
CK Y 0 CASH
L IBJ 2 7 s O; SEP 3 0 3 400 n