HomeMy Public PortalAbout4958AGNES AVE_Plumbing (3) 76A667 17 s 44® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING I
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO l
PLUMBER S�{ �r"�r� RECEIVED BY READY FOR DATEISSUED
�FIRST INSPECTION /��� 2,1
` YG
ADDRESS yJ �). iTBUILDING
CITY � 14feADDRESS
COUNTY LOCALITY /.
LICENSE NO EXPIRES
NEAREST
PERMIT FEES CROSS ST 5-w
/
i 4 (J '/d/5 d/✓
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
D MAIL
q WATER CLOSET (TOILET) Q O 50 $ J ADDRESS
.per BATH TUB O 50 ® CITY TEL NO
{rte SHOWER O s0 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) Q O 50 �O APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O 50 STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q O 50 ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTE OUTLETS Cv? O 50 -�Q SIGNATURE OF i
Y WATER HEATER Q O 50 PERMITTEE_ i?
SLOPSINK Q o so INSI;ECTION RECORD
FLOOR SINK Q O 50
FLOOR DRAIN Q O SO
DISHWASHER Q O 50 1 ry 9 `�,� }� �n pL+�,,,�
DRINKING FOUNTAIN O 50 !W )�L R r. 7Vt)"rr/0�,�A / r=o
URINAL Q O 50
O HOUSESEWER O 50
z
MISCELLANEOUS (�
O
APPROVALS
DATE INSPECTOR S NAME
ROUGH PLUMBING ZD/irp r�f•L-,.��1A�__
GAS PIPING
GAS VENT
CESSPOOL Q 1 00 CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1 00 SEWER
PERMIT 1 00 GAS TEST
UTILITY CO NOTIFIED J
TOTAL FEE $
FINAL r//eeI179