HomeMy Public PortalAbout5113AGNES AVE_Plumbing 76A667 CE817 6-60 �r J ob 167
APPLICATION FOR PLUMBING PERMIT �
DEPARTMENT OF COUNTYGE�NEGINEER
JOHN A AAMB E SAFETY DNGINEER BUILD 11 Agnes Ave.
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM OWNER R. J. Farrell
2 WATER CLOSET MAIL
1 BATH TUB ADDRESS
CITY TEL. NO
1 SHOWER
2 LAVATORY CONTRACTOR
1 SINK
ADDRESS 11900 E. Garvey Ave.
1 DISHWASHER CITY El Monte TEL. No GI 89836
CONTRACTOR S STATE 09
1 LAUNDRY TUB REGISTRATION NO 179 68 COUNTY El
1 CLOTHES WASHER DISTRICT NO GROUL I ZONE/ PR ESSED BY
WATER HEATER G /
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
a
G e
o
0 $1 W PER ITEM ! 7s'B°Cf�v�C�1 /
12 OR FD=RE S 12.00 APPROVALS DATE INSPECTORS SIGNATURE
PERMIT 2 00 UNDER SLAB WORK
TOTAL FEE JVE
1ROUGH PLUMBING 2, 0
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
AND STATE THAT THE ABOVE IS CORRECT AND AGREEY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTEPLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANF GAS TEST ,r
CALIFORNIA OR THAT I AM THE LEGAL ER OFE
DESCRIBED RESID I PROPERTY UTILITY CO NOTIFIED 717
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SIGNATURE A n 01 Y,41 0. A
OF PERMITT FINAL �'0 vt �-
Or /�^��VALIDATION ROBERT A WOOD
III o CASH SUPERVISING MECHANICAL ENG R
1�,��7 8 0 5 3 1 5 D 14 0 0 t