HomeMy Public PortalAbout5136AGNES AVE_Plumbing (4) 76A667 CE#8172 62 TEMPLE F}m CITY'
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING / N'`
JOHN A LAMBIE COUNTY ENGINEER ADDRESS �� V /Y
WILLIAM A JENSEN SUP 7 OF BUILDING
A A4
LOCALITY
FOR APPLICANT TO FILL IN
NEAREST
OSS ST / /�` G
NUMBER FIXTURE OR ITEM EACH FEE ZO
OWNER
WATER CLOSET $1 MAIL
BATH TUB 1 25 ADDRESS f
SHOWER 1Z5CITY TEL NO
LAVATORY 125 CONTRACTOR
SINK 125 ADDRESS
DISHWASHER 125 CITY TEL NO
LAUNDRY TUB 1 25 CONTRACTOR S STATE ❑
REGISTRATION N COUNTY p
CLOTHES WASHER 125 DISTRICT NCf GROUP ZONE SSED BY
WATER HEATER 150
GAS SYSTEM OUTLETS 1 50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30
INSPECTION RECORD09
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Jnr 0.
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING ll
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT i
WITH
L COUNTY ORDINANCES AND STATE LAWS REGULATING
PLMBINGHOT WATER HEAT
I HEREBY CERTIFY THAT 1 AM OPERLY REGISTERED AND/OR PLUMBING FIXTU ES y ;
LICENSED AS REQUIRED BY LO NGELES COUNTY AND STAT F GAS TEST
CALIFORNIA OR THAT T LEGAL OWNER O AN O
RESIDE IN THEA E DE ED DEN TY UTILITY CO NOTIFIED y�
SIGNATURE
OF PERMITTE
FINAL
MMATION ROBERT A WOODo CASH SUPERVISING MECHANICAL ENG R
L.ACO 4 3 7 7 JAN 1 4 5 D 5,00-
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