HomeMy Public PortalAbout5812AGNES AVE_Plumbing 76 A67
DBS 17 3 35 APPLICATION 1
DIVISION OF BUILDING AND SAFETY r
Department of County Engineer
County of Los Angeles
WM J FOX COUNTY ENGINEER BUILDING
i ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OWNER
MAIL DISTRICT NOS GRI OUP ZONE READY FOR INSPECTION
` T
ADDRESS c.:7 Ii -Y' /^? 1
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER �j - INSPECTION RECORD
ADDRESS (✓ r�^']j7 LQ st
r
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CITY +y�[� TEL NO
LICENSE NO / fp � 3 c
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATERWATER CLOSET (TOILET) S
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
PERMIT
ROUGH PLUMBING
S I 1 00
GAS PIPING
TOTAL FEE , GAS VENT
1 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 REGULATING PLUMBING FIXE URES
PLUMBING
1 HEREBY CERTIFY THAT I AM -ROPERLY REGISTERED AN /OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND ST � OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF TH BOVE UTILITY CO NOTIFIED
DESCRIBED RES IDENT]ALIROPER
SIGNATURE
OF PERMITTEE - FINAL �^ S(o
WILLIAM J FOX COUNTY ENGINE R VALIDATION R A WOOD CHIEF PLBG INSPECTOR
r - eg DEC 13 3 200 1D
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