HomeMy Public PortalAbout5703AGNES AVE_Plumbing (11) DEPARTMENT OF COUNTY ENGINEER L U M B I
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J FOX COUNTY ENwNEER ADDRESS 'J� (rs
FOR APPLICANT TO FILL IN LOCALITY
BUILDING7 CROSS ST `a 03
ADDRESS J
r/ v DISTRICT GROUPNE PERMIT NO
LOCALITY
NEAREST I
CROSS ST RE ED BY Ready for I pton DATEISSUED
OWNER r oZ �� • _�/ `�
MAIL q INDUSTRIA
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PLUMBER
ADDRESS
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LICENSE rI COUNTY J
PERMIT FEES a
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VUMFIER TYPE OF FIXTURE OR ITEM FEE ur
WATER CLOSET(TOILET) @ 080 $ m
O
BATH TUB @ 080
SHOWER @ 080
LAVATORY(WASH BASIN) @ 080
KITCHEN SINK @ 0 BO
LAUNDRY TUB OR TRAY @ 0 80 /O
SLOP SINK @ 0 80
FLOOR SINK @ 0 80
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM OUTLETS @ 1 00
WATER HEATER @ 1 00
MISCELLANEOUS
O APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE ,L j, GAS PIPING
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANCELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN
ER OF THE ABOVE SCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE /y�A
OF PERMITTEE ���L _ _
FINAL
76A667 DBS 17 1/53