HomeMy Public PortalAbout5136AGNES AVE_Plumbing r D
-/-,eellvl�vj & 6/,,.
76A607 CE817rO6O aF
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGDMER
BUILDING AND SAFETY DMSION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS gp 4.k
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEARSCROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
ADDRESS ji3
HATH TUB
CITY C N
SHOWER TEL
CONTRACTOR
LAVATORY el
ADDRESS lay
SINS 2,1
DISHWASHER CITY TEL NO
NTRACTOS STATE
LAUNDRY TUB / � EGISTRATION NO L COUNTY
CLOTHES WASHER S DISTmar Naol TP D B
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL �.
INSPECTION RECORD a
O
U
cc
�0
IL
n.
Vf
$100 PER ITEM
OR FWURE $ C>?, G' APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I0ACKNOWLEDGE THAT 1 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 T I AM PROPER EGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS RECU D BY LOS ANGEL UN ND STATE OF v
CALIFORNIA OR AT 1 M THE LE L W F THE ABOVE GAS TEST
DESCRIBED RES ENTIA ROPE RTY UTILITY CO NOTIFIED
SIGNATURE
OF FERMI FINAL�� 1 /Gs�
VATID TIQA OBERT A WOOD
cK M o �(j cash SUPERVISING MECHANICAL ENG R
L�Lo 4 :ti JAIl1 21 5 0 450-
V'