HomeMy Public PortalAbout5117AGNES AVE_Plumbing (7) 76A667 17 IS as® APPLICATION FOR PERMIT ,
DEPARTMENT OF BUILDING AICD SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FIL04Ca..� DISTRICT O GROUP ZONE PERMIT NO
6, 12- 76
PLUMBER RECEIVED BY READY FOR DATE ISSUED '
FIRST INSPECTION
ADDRESS BUILDING / �� 55/CITY i TEL NOADDRESS l `�7�
COUNTYLOCALITY
LICENSE NO EXPIRES
NEAREST '020,sPERMIT FEES cRoss ST
NUMBERTYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) @ O 50 ADDRESS
BATH TUB @ O 50 CITY TEL NO
SHOWER @O 50 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ O 50 n
SIGNATURE OF
WATER HEATER @ O 50 PERMITTE
SLOP SINK @ 0 501 INSPECTION RECORD
FLOOR SINK @ O 50
FLOOR DRAIN @ O 50
DISHWASHER @ O 50
DRINKING FOUNTAIN @ O 50
URINAL @ O 50
� J
HOUSE SEWER (7n O 50 Q
Z
MISCELLANEOUS ('
0
APPROVALS
DATE INSPECTOR S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1 00 CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( @ 1 00 SEWER
PERMIT 1 O0 GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE S ,�/'
w FINAL