HomeMy Public PortalAbout4943AGNES AVE_Plumbing (2) 177 10 5S
DESAPPLICATION FOR PLUMBING PERMIT
DBS I
DIVISION OF BUILDING AND SAFETY
It Depcutment of County Engmeer
County of Los Angeles BUILDINGf�
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST I
OWNER DISTRICT NO ROUPI
�S ZONE I READY FOR INSPECTION
ADDRESS &- 74 � I
CITY TEL N -ff-J` INDUSTRIAL
WASTE APPROVAL
PLUMBER cy-y� INSPECTION RECORD
L
ADDRESS
CITY TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00
BATH TUB @ $1 00
SHOWER @ $1 00
LAVATORY (WASHBASIN) @ $1 00
KITCHEN SINK @ $1 00
DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $100
WATER HEATER @ $1 00
GAS SYSTEM @ $1 00
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK - '%7
P $ I ROUGH PLUMBING
PERMIT 1 00
GAS PIPING
TOTAL FEE
GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 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
I 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 OAF! HE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIA PERTY
PR
SIGNATURE
OF PERMITTEE FINAL i
IOHN A LAMBIE COUNTY ENGINEER -,---VALIDATION ROBERT A WOOD CHIEF PLBG I SPECTOR
C M 0 CASH
LACO 6 9 2r8 t APR 8 3 4 0 0 �