HomeMy Public PortalAbout5732AGNES AVE_Plumbing (2) DES 17 APPLICATION FOR PLU BANG PERMIT
DBS 17 3DIVISION OF BUILDING AND SAFETY
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Deportment of County Engmeer Z I
County of Los Angeles
WM J FOX COUNTY ENGINEER BUILDING
' CASSATT D GRIFFIN SUP T OF BUILDING ADDRESS
FOR APP NT TO FILLffl NEARESTY /
CROSS ST
OWNER DISTR�JCT NO FGOUP ZONE READY FOR INSPECTION
MAIL C—
ADDRESS
CITY EL �(((llf���� INDUSTRIAL
WASTE APPROVAL
PLUM t INSPECTION RECORD
1
ADDRESS
CIT TEL NO
LICEN NO Q Q' �v t/21-7 7
NUMBER TYPE OF -
FIXTUREOR ITEM FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO @ 080 APPROVALS
DATE INSPECTOR S SIGNATURE
GAS SYSTEM OUTLETS @ 1 00
WATER HEATER 1 00 UNDER SLAB WORK
ROUGH PLUMBING
PERMIT S 1 00
GAS PIPING
TOTAL FEE Olt GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 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 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 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED r
DESCRIBED RESIDENTIA e
R 90,RTY r
SIGNATURE 4
OF PERMITTEE FINAL
r V
WILLIAM J FOX COUNTY ENGINEER VALIDATION R A WOOD CHIEF PLBG INSPECTOR
6 1 1 5 JUL 2 9 3 200 to
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