HomeMy Public PortalAbout4949AGNES AVE_Plumbing (5) 76AG67 CEA817 4 67
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t APPLICATION FOR PLUM PE IT
'COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
ITX
COLEMAN W JENKINS SUPT OF BUILDING LOCAL
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNEF
WATER CLOSET "25 MAIL
BATH TUB 1 25 ADDRESS
SHOWER 125 CIT TEL N Q
LAVATORY 125 CONTRACTOR
SINK 125 ADDRESS loeAP6
DISHWASHER 1 25F CIT TEL NO 5L -
STATE �//^ 1 LI C
LAUNDRY [UB 125 LICENSE NO CLASS
CLOTHES WASHER 1 25 DISTRICT NO GR O ZONE j P D BY
WATER HEATER 1 50
GAS SYSTEM-' OUTLETS 150 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD /
o
U
U
Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 I 00 UNDER SLAB WORK
-100 ROUGH PLUMBING
TOTAL FEE
CAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT M THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABO DES FESID NTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERM ITTE
FINAL
ALIDATION JACK R ALLEN
M D CASH SUPERVISING MECHANICAL ENG R
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