HomeMy Public PortalAbout5211AGNES AVE_Plumbing (5) P
7GA667 D95 17 7 51 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
R ZONE —PYffMIT NU
FOR APPLICANT TO FILL IN S
PLUMBER _ • tri r RECEI PED 93Y READY FOR DATY ISSUED
�7 FIRST INSPECTION
ADDRESSZZ/�
BUILDING"4a// Z
CITY L�y�Q7j(r.- TENo ADDRE86
COUTY 2 y3 I LOCALITY
N
BE NO I EXPIRE / Q S_y
NEAREST
PERMIT FEES CRO®BST
NUMBER TYPO OF FIXTURE OR STEM FEE
OWNER
MAIL
WATER CLOSET(TOILET) 050 ADDRESS
BATH TUB @ 050 CITY TEL No
SHOWER @ O5O 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ Q 5D {APPLICATION AND STATE THAT THE ABOVE IS CORRECT
1 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK Q Q 5Q AND STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY a 050 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE REBIDENTIALRROPERTY DESCRIBED ABOVE
GAS SYSTEM OUTLETS @ 0 50
SIGNATURE OF
WATER HEATER 050 PffRMITTE'c
SLOP SINK ® C sC ` INSPECTION RECORD
FLOOR SINK O sD I
FLOOR DRAIN O 50 ` m
DISHWASHER Q O SO 157 ��
I
DRINKING FOUWrAIN O 50 b &1 d
4
URINAL O SO SQL+. cL 'I
�1 Q
HOUSE SEWER 050
MISCELLANEOUS O
APPROVALS
DATE IN®PECTOR a NAM[
ROUGH PLUMBING
GAq PIPING
GAS VENT
CESSPOOL 1 D CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT 00 SEWER
PERMIT 100 GAS TEST
�� UTILITY CO NOTIFIED
TOTAL FEE >s ,w
FINAL v r2