HomeMy Public PortalAbout4846 AGNES AVE_Plumbing_10/2/1961_water heater Jt
76A66/CE6T7 6 60 n
APPLICATI0 FOR PL MBING PERMIT
DEPARTMENT OF COUNTVY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY _
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET HAIL
RATE TUB ADDRESS
CITY TEL NO
SHOWER
LAVATORY CONTRACTOR
SINS ADDRESS ,�
DISHWASHER CITY TEL NO
CONTRACTOR S v ATS
LAUNDRY TUB I REGISTRATION NO Y COUNTY
CLOTHES WASHER DISTRICT GROUP ZONE/ PR ED BY
WATER HEATER 'r /`'1 I
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
a
O
V
al
0
W
w
N 51 00 PER ITEM
OR FD[TURE $ APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ Z 00 UNDER SLAB WORK
TOTAL FEE �—� ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER �Dl�
PLUMBING
1 HEREBY CERTIFY THAT I A PROyERLY R ERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LO ANGELES CO 7Y AN S ATE OF GAS TEST I
DESCRIBED RESIDENTIAL P CALIFORNIA OR THAT I M ERT HE LEGAL 0 !% OF ABOVE UTILITY CO NOTIFIED - ) I Lf/
SIGNATURE / I /�
OF PERMITTEE— FINAL
®I VALIDATION ROBERT A WOOD
® 0 cAsa SUPERVISING MECHANICAL ENG R
3 ' c o OCT 2 5 Q .3 r C a
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