HomeMy Public PortalAbout5210AGNES AVE_Plumbing (13) 76 A 667—CE 817 8/68
L
APPLICATION PLUM NG PER T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY -
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST Q
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 150
MAIL 7
BATH TUB 1 50 ADDRESS
SHOWER 1 50 CITY TEL NO _
LAVATORY 1 50 CONTRACTO
SINK 1 50 ADDRESS
DISHWASHER 150 CITY �J /�j TEL NO
CLOTHES WASHER 1 50 STATELIC
LICENSE NO y�l jj� CLASS
SWIA1AtING POOL RECEPTOR 1 SO DISTRICT NO GROUP ZONE PR ESSED BY
I AWN SPRINKLER SYSTEM 2 00 57 ' T
- 1 V
WATER HFATER 1 50 INDUSTRIAL -I� Z
WASTE APPROVAL o
GAS SYSTEM OUTLETS 1 o0 INSPECTION RECORD V
w
OUTLETS OVER d
5 PER SYSTEM 30 Z
Plan cliec.k fee 2,% of abo%e See reverse
PLUNIBINC PERMI P ISSIIIN( F FF S 2 00
IOTAI FFE 3 1�J
APPROVALS DATE INSPECTOR S SIGNATURE
Plan cherk -ipplic int UNDER SLAB WORK
Name ROUGH PLUMBING
Address CAS PIPING
GAS VENT
Clt) lel No HOT WATER HEATER
IH
ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIB RE81DENTIAL PERTY FINAL
SIGNATURE JACK R ALLEN SUPERVISI CHANICAL ENG R
OF PERMITTEE
PERMIT VALIDATION cK M O CASH
PLAN CHECK VALIDATION CK M O CASH
350-
1