HomeMy Public PortalAbout5836 ALESSANDRO AVE_Plumbing__ 76A667C ICE 817E3) 9/75
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS p,
46
WATER CLOSET LOCALITY
NEAREST w
BATH TUB CROSS ST -u{/
SHOWER 04NER
LAVATORY MAI L
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTO
CLOTHES WASHER
ADDRESS 0
SWIMMING POOL RECEPTOR
CITY �� JQ TEL
LAWN SPRINKLER SYSTEM
STATELIC
WATER HEATER LICENSE NO � CLASS C)
DISTRICT NO GROUP �ZgNE RO SSED BY V
GAS SYSTEM OUTLETS �� �t r O
OUTLETS OVER C/ V
5 PER SYSTEM INDUSTRIAL �
WASTE APPROVAL
I NSPEC TI ON REC ORD
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE "7 1-1
Plan check applicant
Name APPROVALS DATE INSPECTOR 5 SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT IHAVE 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
PLUMBING
I HEREBY CERTIFY T T I AM PROPERLY RE STERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRE Y LOS ANGELES COUN AND STATE OF GAS TEST
CALIFORNIA OR THAT AM HE LEGAL OWNER AN INTEND TO
RESIDE IN THE ABOVE SCR B D RESIDENTIAL UTILITY CO NOTIFIED
SIGNATU RE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION K M D CASH PERM( VALIDATION OC
M D CASH
5 3 7 �4 EB t) n�