HomeMy Public PortalAbout4948AGNES AVE_Plumbing (6) h 76A667 17 25M SETS 7 4e APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
IZ COUNTY OF LOS ANGELES
° WILLIAM J FOX, CHIEF ENGINEER PLUMBING 1
FOR APPLICANT TO FILL IN DISTR RO P P
PLUMBER READY FOR
RECEIVED/BYFIRST INSPECTION TE IS�UED
ADDRESS /�/(/// r////^I
CITY TEL No JOB
ADDRESS rb+l
COUNTY
LICENSE Nn EXPIRES LOCALITY �� r'l.. f lf'W�l
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEAREST
ANGELES COUNTY LICENSE CROSS ST
OWNER
MAIL �p
PLUMBER ADDRESS /J✓fl �rA�r ,.l..G �d9 . (�
PERMIT FEE IS $1 00 FOR THE FIRST FIXTURE OR CITY ��., .Q9¢'� 4�s,�i�j TEL NO
ITEM LISTED BELOW PLUS 50c FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP
ITEM FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE
$1 00 MINIMUM FEE FOR ANY PERMIT $1 00 EACH � � M1
GAS SYSTEM IS A SEPARATE ITEM �a f
OWNER
NUMBER TYPE OF FIXTURE OR ITEM
CORRECTIONS
WATER CLOSET (TOILET)
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
LAUNDRY TUB OR TRAY
GAS SYSTEM OUTLETS
WATER HEATER
SLOP SINK
Q
FLOOR SINK a
FLOOR DRAIN L7
Q'
DISHWASHER O
DRINKING FOUNTAIN
URINAL
MISCELLANEOUS
APPROVALS
DATE INSPECTORS NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL
SEPTIC TANK DRAIN ( ) PIT ( ) $ SEPTIC TANK
CESSPOOL $ SEWER
HOUSE SEWER $ GAS TEST
TOTAL FEE $ / ///1 UTILITY CO NOTIFIED
( v lJ FINAL