HomeMy Public PortalAbout5745AGNES AVE_Plumbing 76A6fi/CE817 12/59
APPLICATION FOR PLUMPING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING {}�u DIE�AFETY 121VISION BUILDING
JOHN A LAMBIt COUNTY tNGINEER ADDRESS .��' /(/ r A&A..,e�
WILLIAM A JENSEN SUP T OF BUILDING
mm LOCALITY
FOR APPLICANT TO FILL IN NEAREST1�
CROSS ST
NUMBER FIXTURE OR ITEM
OWNER G
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL NO
SHOWER _
LAVATORY CONTRACTOR ��f b
SINK ADDRESS /YO lC (.
DISHWASHER CITY M 0 A4000 l/t eZEL NO 5-7�Z/Q?
CONTRACTOR S // STATE
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LAUNDRY TUB REGISTRATION NO l 3 COUNTY ❑
CLOTHES WASHER DISTRICT NO GROUP I ZONE P gESSED BY
WATER HEATER U
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORDro
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U
U
w
a
N
3 Q $1 00 PER ITEM
OR FDITURE $ 3 &0 APPROVALS S DATE/ INSPECTOR
.,S.,/SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE p ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
ft
SIGNATURE �.�.►
OF PERMIiTE 1 FINAL ZO
OF VALIDATION ROBERT A WOOD
cic m 0 CASH SUPERVISING MECHANICAL ENG R
LIi{_'c 4 2 5 9 -0 IA ?2 5 D 5 00