HomeMy Public PortalAbout5004AGNES AVE_Plumbing (6) L COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
VISION OF BUILDING & SAFETY O L U B I N G 1
WILLIAM J FOX County Engineer Q
FOR APPLICANT TO FILL IN D 1z7P I /7 ® 74�$—
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_e1-uM{3ER 7 Y �JC�L C/ RECEIV Q READY FOR DATE ISSUED
_ FIRST INSPECTION
ADDRESS n l S/
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CITY TEL Na
COUNTY
LICENSE NO G ,�� EXPIRES LOCALITY
NEAREST
PERMIT FEES CROSS 9T
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) O SO B ADDRESS
BATH TUB @ O SO CIT. TEL. NO
SHOWER @ 050 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) Q 050 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 050 AND STATE LAWS REGULATING PLUMBING
_ I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 050 ANGELES COUNTY LICENSE OR I AM LE Al^OWNER
GAS SYSTEM OUTLETS @ 050 OF THE RESIDENTIAL PR 1! BE RI E
WATER HEATER O 50 SIGNATURE OF
PERMITTEE
SLOP SINK @ 050 INSPf CTION RECORD
FLOOR SINK (s>2 O 50
FLOOR DRAIN Q 050
DISHWASHER @ O 50
i
DRINKING FOUNTAIN @ 050
URINAL 0513
Q
HOUSE SEWER Q 050 Z
MISCELLANEOUS _0
J h / O
APPROVALS
DATE INSPECTORS NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL 10O CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT—(—)-- 1 00 SEWER
PERMIT 1 GD GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE7$
l FINAL
17
7GA667 DBS$17 10/52