HomeMy Public PortalAbout5939,5939 1/2 ALESSANDRO AVE_Plumbing__ 76A667 (CE-817) 8 71 J G `����
APPLICATION FOR PLUMBING PER�IV� T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FNEARIEST
UILDING �E—SS
BUILDING AND SAFETY DIVISION DDRESS
OCALITY
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FOR APPLICANT TO FILL IN (PRINT OR TYPE) ROSS ST 6
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1 75 '
MAIL `/
BATH TUB 1 75 ADDRESS ///,1 :2L_
SHOWER 1 75 CITY �r TEL No
LAVATORY 1 75 CONTRACTOR �-
SINK 1 75 ADDRESS
DISHWASHER 1 75 CITY rZ,,t,,01 T TEL NO
CLOTHES WASHER 1 75 STATE LIC
LICENSE NO . CLASS
SWIMMING POOL RECEPTOR 1 75
DIS�ICT N UP Z NE P BY
LAWN SPRINKLER SYSTEM 1 75 10O f'/jr
WATER HEATER 1 76 INDUSTRIAL 96
WASTE APPROVAL G
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD V
OUTLETS OVER 30 Z
5 PER SYSTEM
P
V
W
Vf
z
Plan check fee See reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name
ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE EGAL OW ER OF A INTEND TO
RESIDE IN THE ABOVE DES CRIB D RE51D IAL PRO FINAL
l
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION OMO CASH
PLAN CHECK VALIDATION CK M 0 CASH
Ao 6 3 &-t JUN 1 ,_` 475-
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