HomeMy Public PortalAbout5954 ALESSANDRO AVE_Plumbing__ PA l
76A667 (CE 817) 8 71 v
APPLICATION FOR PLUMBING PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERLD I NG
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BUILDING AND SAFETY DIVISION
7'
BUILDING
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LOCALITY T� L=
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST
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WATER CLOSET 1 75 d
OWNER -I
MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY LG TEL NO 2
LAVATORY 1 75 G CONTR G
SINK 1 75 ADDRESS
DISHWASHER 1 75 CITY TEL NO -3
CLOTHES WASHER 1 75 STATE LIC /� J
SWIMMING POOL RECEPTOR 1 75 LICENSE NO kZ 6 2— CLASS
DISTRICT NO G606 ONE ROCESSED BY
LAWN SPRINKLER SYSTEM 1 75 c O 1 1' _ _3
WATER HEATER 1 75 00 INDUSTRIAL
WASTE APPROVAL G
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD
OUTLETS OVER 30
5 PER SYSTEM O
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Plan check fee See reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING _7
Address GAS PIPING
City Tel No GAS VENT )
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS 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 LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION cK M o CASH
PLAN CHECK VALIDATION CK M o CASH
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