HomeMy Public PortalAbout4820 ALESSANDRO AVE_Plumbing__ 'P6AH67A
CE 817(REV'9/78) /
0S V
APPLI T NFO PLUM "I G PERMIT'
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING AjorQ.Z
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NUMBER FIXTURE OR ITEM @ FEE ADDRES
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST /
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINKtZo bTY TEL N CM 9
DISHWASHER CONTRACTOR
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CLOTHES WASHER ADDR O
c P
SWIMMING POOL RECEPTOR
CITY TEL NO G
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO CLASS
41, i Uii
GAS SYSTEM OUTLETSlltzp APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
9 GAS PIPING
GAS VENT u
HOT WATER HEATER -
PLUMBING FIXTURES
GAS TEST 6
Plan check fee A., UTILITY CO NOTIFIED
k PLUMBING PERMIT I 1 G FEE$
OTAL FEE FINAL "VILA I
Plan check applicant *m PLAN CHECK VA D .
Name �//� /✓✓✓/
Address
L99808A
City Tel NO
I HEREBY ACKNOVILEDGE THAT I HAVE READ THIS APPLICATION AND STATE # O O O o,0,5
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION 2 a v 1,000
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES C AND STATE OF CALIFORNIA OR THAT I AM THE �' O O 0 11000'0
LEGAL OWNER OF AND IN D TO RESID E ABOVE DESCRIBED RESIDENTIAL
PROPERTY 1 a 4/1s It O'4(J'O
SIGNATURE
O P2'RMi`FF£
NO / PR CESSED BY
INDUSTRIAL
WASTE APPROVAL