HomeMy Public PortalAbout4949AGNES AVE_Plumbing 76A667 DBS 17 11 50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
DISTRICT O P O M N
FOR APPLICANT TO FILL IN � T' g-1 15 17 Z
PLUMBER.41 � READY FOR
/` i �I/, / i /� RECEIVED BY DATE ISSUED
+Q-7 / FIRST INSPECTION
ADDRESS
BUILDING
CITY TEL. N-A 7 n a ADDRESS y i d 14 4z
COUNTY LOCALITY / i
LI NSE NO Q EXPIRES
NEAREST
PERMIT FEES CROSS ST wdo
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 40/101>r- , / /,{1 As C
MAIL
WATER CLOSET(TOILET) @ 050 $ ADDRESS
BATH TUB @ O 3O CITY TEL No
SHOWER O 50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 050 AND STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 050 ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY EBCRIBED ABOVE*
GAS SYSTEM OUTLETS @ 0 50 _
SIGNATURE OF �,
WATER HEATER @ O 50 PERMITTE
SLOP BINK @ 0513 INSPEC ION RECORD
FLOOR SINK @ O 50
FLOOR DRAIN @ O BO �b
DISHWASHER @ O 50
DRINKING FOUNTAIN @ 0513
URINAL O 50 J
Q
HOUSE SEWER Q 050 Z
MISCELLANEOUS l9i,N l
0
I
I
APPROVALS
DATE INSPECTOR S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 100 CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1 OO I SEWER
PERMIT I 1 00 GAS TEST
2 UTILITY CO NOTIFIED
TOTAL FEE $
FINAL