HomeMy Public PortalAbout5703AGNES AVE_Plumbing (10) DEA° APPLICATION FOR PLUMBING PERMIT 1
DBS I77 f0 S5
DMSION OF BUILDING AND SAFETY
Department of County Engmeer
County of Los Angeles BUILDING �!]B�
JOHN A LAMBIE COUNTY ENGINEER ADDRESS //
CASSATT D GRIFFIN SUP T OF BUILDING 1
LOCALITY
FOR APPLIC T TO FILL IN NEAREST
CROSS ST
OWNER DISTRICT NO I GROUP I tZONE I READY FOR INSPECTION
MAIL ,y
ADDRESS (l
INDUSTRIAL
CITY TEL N941 IJ4v WASTE APPROVAL
PLUMBE giJ�L-/ 'CC/)� INSPECTION RECORD
ADDRESS
CITY TEL N _ 0<<(�
LICENSE O
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00 $
BATH TUB @ $1 00
SHOWER @ $1 00
LAVATORY (WASH BASIN) @ $1 00
KITCHEN SINK @ $1 00
DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $1 00
WATER HEATER @ S100 490
GAS SYSTEM @ $1 00
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE of GAS PIPING
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I MTHE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIA RI
ER TY
SIGNATURE
OF PERM I T T E E FINAL
'OHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CK E1 0 CASH
,04700C; DEC 2 3 200