HomeMy Public PortalAbout5732AGNES AVE_Plumbing 7O
6DBS A6I7 73 53 Y APOLICATION FOR PLUMBING ■ EB ■MIT 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles
WM J FOX COUNTY ENGINEER BUILDING •�
ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING
Ing LOCALITY
FOR APP CANT TO FILL I NEAREST
CROSS ST
OWNER
DISTRICT NO GROUP ZONE READY FOR INSPECTION
MAIL s �j
_ADDRESS
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMB INSPECTION RECORD
ADDRESS
CIIITpY q TEL N
CiCENS NO a( y 3 rz;& /01 ?J?_
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
t
TOTAL NO @ 080 APPROVALS
GAS SYSTEM OUTLETS @ 1 00 DATE INSPECTOR S SIGNATURE
O UNDER SLAB WORK
WATER HEATER (cJ 1 00
ROUGH PLUMBING
PERMIT g 1 00
GAS PIPING
TOTAL FEE O GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER �{�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGPLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RES IDENTIA PROPERTY
SIGNATURE
OF PERMITTEE FINAL
WILLIAM J FOX COUNTY ENGINEER VALIDATION R A WOOD CHIEF PLBG INSPECTOR
_,C0 h 1 1 ?in JLJL 2 9 3 200 In
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