HomeMy Public PortalAbout4935 ALESSANDRO AVE_Plumbing__ 76AC67 CENS17 9/63 / t
APPLICATION FOR PLUMBING PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ,
BUILDING AND SAFETY DMSION ADIDHESS "
JOHN A LAMBIE COUNTY ENGINEER �'�-��
WILLIAM A JENSEN SUPT OF BUILDING 1
LOCALITY
FOR APPLICANT TO FILL IN NEAREST f
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE OWNER (✓t
WATER CLOSET $1 25 . e P
MAIL f�
BATH TUB 125 ADDRESS _s
SHOWER 125 �� CITY TEL NO
LAVATORY 125 , CONTRACTOR �
SINK 125 ADDRESS
DISHWASHER 125 CITY TEL NO 331�-fl J_00
LAUNDRY TUB 125 CONTRA ORS STATE
REGIS TION NO r�.{>� COUNTY ❑
CLOTHES WASHER 125 DIST ICT NO GROUP ZONE PR ESSED BY
WATER HEATER 150s O� q1—�pJ
f (f
GAS SYSTEM OUTLETS 150 INDUSTRIAL
d
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD V
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F-
V
W
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Z
APPROVALS DATE INSPECTOR 5 SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK �,� L
ROUGH PLUMBING
TOTAL FEE ZC GAS PIPING t
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES /!,� r_
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 ABOV�DES IBEDRESIDENTIAL PROPERTY UTILITY CO NOTIFIEDSIGNATURE //l♦OF PERMITTEE �^I
FINAL 1 14-`1 ieo
V LIDATION ROBERT A"WOOD _ r
cK M o CASH SUPERVISING MECHANICAL ENG R
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LALs) 2 8 6 1 0 AUG 2 0 5 D 7 2 5N v