HomeMy Public PortalAbout5009AGNES AVE_Plumbing (4) 76A667-CE817 6-60 =/
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APPLICATION FOR PLUMBIN PERMIT
COUNTY
OCOUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS lT
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST 7� lJJ p ) CL
CROSS ST. L R V -5
NUMBER FIXTURE OR ITEM C G
OWNER
WATER CLOSET Z MAIL
BATH TUB ADDRESS
CITY TEL NO.
SHOWER
7
CONTRACTOR h",ON FIFEY (�^-,RK PLUMBING CO. INC.
LAVATORY
SINK ADDRESS 418 SO. GAR
FIELD
DISHWASHER
CITYMUNI .`
MUMMA
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTfj_QT NO. GROUP ZONE PROCES D 13Y
WATER HEATER - } .�/
!'r J A INDUSTRIAL
GAS SYSTEM
WASTE APPROVAL
INSPECTION RECORD
a
O
U
O
F
U
W
W
V1
�PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
t
SIGNATURE
OF PERMITTFIT
FINAL
Or VALIDATION ROBERT A. WOOD,
CK U.0. CAIS SUPERVISING MECHANICAL ENG'R
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