HomeMy Public PortalAbout5009AGNES AVE_Plumbing W
DOS
DAPPLICATION FOR PLUMBING-PERMITDBS 17(DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS lfJ
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST i..
OWNER DISTRICT NO I GROUP I ZONE I READY FOR INSPECTION
MAIL ��}}/�
ADDRESS 01
INDUSTRIAL
CITY EL NO WASTE APPROVAL
PLU M B E / IrL INSPECTION RECORD
ADDRESS L �y 0 /
CITY v L
LICENSENO ct[l {
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00 60
BATH TUB @ $1 00
SHOWER @ $100
LAVATORY (WASH BASIN) @ $1 00 l 00
KITCHEN SINK @ $1 00
DISHWASHER @ $1 00
LAUNDRY TUB OR TRAY @ $100 0
CLOTHES WASHER @ $1 00
WATER HEATER @ $100
GAS SYSTEM @ $1 00
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
dv GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES [�C4
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY,
SIGNATURE �1,��yJ[
OF PERM ITT E> FINAL {eo A"D
JOHN A L.AMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CK ma
CASH
LA
CO3 M24 3 440
F J