HomeMy Public PortalAbout5004AGNES AVE_Plumbing (7) b B 17 IOM 8[T9 ,:41 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WM J FOX CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT O GROUP ZONE PERMIT NO
ROUGH FIXTURES COMPLETE k ?e
RECEIVED
BY READY FOR DATE ISSUED
HEATER CESSPOOL SEPTIC TANK I //��6"'V✓ FIRST INSPECTION
GAS MISCELLANEOUS �[ J M'
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
NAME J
� ADOBDRESS
W ^
m _ADDRESS /,23 LOCALITY
O NEAREST
a _CITY TEL No CROSS ST
COUNTY
CERT NO EXPIRES K NAME
W
LOCATION OF SEPTIC TANK,OR CESSPOOL 3 MAIL
ADDRESS
NORTH O
CITY TEL No
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICAT OF Q ALIFIICAATIIONN
id � 2.-
' I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
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s
w
3 U) OWNER
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK Z
BATH TUB FURNACE
SHOWER DISHWASHER
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN
DATE INSPECTOR S NAME
WATER HEATER _ DENTAL LAVATORY
ROUGH PLUMBING
METER GAS SODA FOUNTAIN
OUTL GAS PIPING
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
CESSPOOL- 4EPTIC TANK / SEWER
$ UTILITY CO NOTIFIED
TOTAL FEE
FINAL O