HomeMy Public PortalAbout4937AGNES AVE_Plumbing (4) WD S!3 17 25M SETS 7 47 APPLICATION FOR PERWr I
DEPARTMENT OF BUILDING AND SAFETY
td COUNTY OF LOS ANGELES
Wm J FOX CHIEF ENGINEER PLUMBING
NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT NO
,,
ROUGH FIXTURES COMPLETE
HEATER CESSPOOL
REC6 Y13 BY READY FOR DATE ISSUED
SEPTIC TANK FIRST INSPECTION / Q
AS MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
E NAME /,�i0s�^ ADDRESS ,
W
mADDRESS
g � LOCALITY
//, � �� NEAREST
IL CITY / IJ Wl.� TEL No CROSS BT 1 �
COUNTY /1
CERT No EXPIRES NAME
m ,� V
LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL
3 ADDRESS V
NORTH 0
CITY TEL No
t AM THE LEGAL POSSESSOR OF THE ABOVE LOB
ANGELES COUNTY CERTIFICATE OF RQUALATIO
W IF
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
D
3 OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK a
z_
BATH TUB FURNACE C)
Ir
SHOWER DISHWASHER 0
LAVATORY - REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR BINK SAND TRAP
GLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR 8-NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
-METER-GAS SODA FOUNTAIN
OUn GAS PIPING
1 GAS VENT
CESSPOOL I:..J �l GSL% I I Y£fL/--.tom"�J
TOTAL NUMBER OF FIXTURES SEPTIC TANK I I
\ I I
CESSPOOL SEPTIC TANK SEWER
TOTAL
UTILITY CO NOTIFIED
FEE I I -
FINAL