HomeMy Public PortalAbout4958AGNES AVE_Plumbing 67—CE 817468 �`� �,
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APPLICATION FOR PLUMBING PER IT U
COUNTY OF LOS ANGELES
i DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
d� WATER CLOSET 1 50 QQ KAIL
BATH TUB 1 so C> ADDRESS 20 Blrchcroft
CITY Arcadia TEL No 446-1658
SHOWER 1 50
LAVATORY1 50 CONTRACTOR Owen Bros. Plumbing, Inc.
SINK " a 1 50 —[) ADDRESS 4265 North Baldwin Ave.
DISHWASHER 150 10 CITY El Monte fl-731 TEL NO 443-0078
CLOTHES WASHER 1 50 0 LICENSE NO 231 741 CLASS C 36
STATE LIC
SWIMMING POOL RECEPTOR 1 50 DISTRICT NO G�UP ZONEESSED BY
LAWN SPRINKLER SYSTEM 2 00 >Q:
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WATER HEATER 1 50 �(,I INDUSTRIAL
WASTE APPROVAL O
GAS SYSTEM OUTLETS 1 50 �� INSPECTI RECORD
OUTLETS OVER
5 PER SYSTEM 30 V /d L I W
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Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE $ 2 00
TOTAL FEE 15—
APPROVALS DATE I IN CTOR 5 IG ATU RE
Plan check applicant UNDER SLAB WORK 1$
Name ROUGH PLUMBING
Ad IreSS GAS PIPING l
GAS VENT
City Tel No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION PLUMBING FIXTURES
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DE CRIBED RESIDENTIAL PROPERTY FINAL
SIGNATURE JACK R ALLEN SUPERVISING CH ANICAL ENG R
OF PERMITTEE
PERMIT VALIDATION cK M o CASH
PLAN CHECK VALIDATION CK M o CASH
5 o IV%R13 5 D 1 �S.rJflN