HomeMy Public PortalAbout5728AGNES AVE_Plumbing (2) 76 A E67—CE 817 8/68 ``_/ �//"/'L i[. l.�l.•it,•Z
APPLICATION FOR PLUMBING PER T
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 2
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEARESTS
CROSS T.
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50_ OWNER
MAIL
BATH TUB 1.50 ADDRESS 7
SHOWER 1.50 CITY G� TEJANO.
LAVATORY 1.50 - CONTRACTOR
SINK 1.50 ADDRESS 7 �
DISHWASHER 1.5041NDUSTRIAL
TE NO.ae
CLOTHES WASHER 1.50TE LIC
ENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO GRO P ZONE PRO - 5S D BY
LAWN SPRINKLER SYSTEM 2.00f I I J COD
WATER HEATER 1.50 U
STE APPROVAL zo
�. GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD C:>
OUTLETS OVER v
S.PER SYSTEM .30 a
Cn
Z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING EEE S 2 00
TOTAL FEE
APPROVALS DATE INSRlECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK '-� ��'-;7
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
IH
ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES g 19
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING. L I
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 DEC RIBED ESIDENTIAL PROPERTY. FINAL
SIGNATURE '
OF PERM JACK R. ALLEN, SUPERVISI N ANIC AL EIJ G'R.
PERMIT VALIDATIO c K !..M.O. CASH
PLAN CHECKALIDATIO CK. M.O. CASH fit__^