HomeMy Public PortalAbout4846 AGNES AVE_Plumbing_3/12/1965_sink L
78A887 CE#81y/9/63 / /
APPLICATION FOR PLUMBING ERMIT
COUNTY OF LOS ANGELES C
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 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 EACH FEE
OWNER
WATER CLOSET $125 MAIL
BATH TUB 125 ADDRESS
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINK 125 ADDRESS O
DISHWASHER 125 c qU NO�J Z lees]
TE
LAUNDRY TUB 1 25 REGISTRATION NO 1p COUNTY ❑
CLOTHES WASHER 125 DISTRICT NO GROUP ZONE PR ESSED BY
WATER HEATER I N
GAS SYSTEM OUTLETS ISO INDUSTRIAL 0
WASTE APPROVAL
OU OVER 5 PER SYSTEM 30 INSPECTION RECORD U
2Y_ Im
O
0
U
W
0-
z Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK f /
ROUGH PLUMBING
TOTAL FEE GAS PIPING ` }
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT J
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIF THAT I 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 AND INTEND TO
RESIDE IN THE ABOVE S IBED ESID TIAL PROPERTY UTILITY CO NOTIFIED ,�/ �` �+�.✓�
SIGNATURE
OF PERMITTEE
1. FINAL
V1 max.
ALIDATION ROBERT A WOOD
cK MIO CASH SUPERVISING MECHANICAL ENG R
1 J 1 LAtic 5 5 4 6 'R 12 5 D 450-
d
x
1