HomeMy Public PortalAbout5117AGNES AVE_Plumbing (2) 7SA667 17 s 49 0 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING I
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRIC NO GROUP ONE PERMIT NO
PLUMBER �, RECEIV D BY IREADfY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS 1 dJ
NG"VTEL NO V ADDREBUILDIS3
COUNTY LOCALITY
LICE O EXPIRES NEAREST
PER T FEES cRoss sr
NUMBER TYPE OF FIXTURE OR ITEM FEE OW E
MAIL
WATER CLOSET (TOILET) Q O SO $
ADDRES,% ;I-,7 C�. e/.��L,Ctl J ,� r 02,
BATH TUB Q O 50 CITY i y ,, TEL Ng5 fff
SHOWER Q O 50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ'THIS
LAVATORY (WASH BASIN) Q O 50 APPLICATION AND STATE/THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK Q O 50 STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 PO ES E ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q O 50 ANGELES COUNTY LICENSE 1 1 E LEGAL OWNER
OF THE RESIDENT L PROPERT ABOVE,
GAS SYSTEM OUTLETS Q O 50
SIGNATURE OF
WATER HEATER Q O 50 PERM ITTE
SLOP SINK Q o so INSPECTION RECORD
FLOOR SINK Q O 50
FLOOR DRAIN Q O 50
DISHWASHER Q O 501
DRINKING FOUNTAIN Q O 50
URINAL O 50 ..I
HOUSE SEWER @ O 50 1 a
Z
MISCELLANEOUS tJ'
0
1
1 APPROVALS
DATE INSPECTOR S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL Q 1 001 CESSPOOL
1 SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1 00 SEWERF=
G V
PERMIT 1 O0 GAS TEST
l
TOTAL FEE UTILITY CO NOTIFIED
$ I V
FINAL