HomeMy Public PortalAbout4803ALESSANDRO AVE_Plumbing (4) 76A667 (CE 817) 1/75
APPLICATION FOR LUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO ADDRESS � O 3
HARVEY T BRANDY COUNTY ENGINEER LOCALITY Ol� 1.P
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST �nJ
CROSS ST (tu C Z nZtcJ� t�
NUMBER FIXTURE OR ITEM p FEE
L., OWNER �
WATER CLOSET 2 0 J MAIL /
BATH TUB 2 0 ADDRESS J�,-/"1 e
SHOWER 2 CITY 7 TEL NO -5/71
LAVATORY 2 CONTRACTOR
SINK 2 0 ADDRESS /v
U.
DISHWASHER `\ 2 0 CITY �u �/�y TEL NO331 L-) el
CLOTHES WASHER 2 0 STATE LIC
�rJ Q�
SWIMMING POOL RECEPTOR 2 p LICENSE NO CLASS
DISTRICT NO GROUP ^ZONE ESSED B
LAWN SPRINKLER SYSTEM 2 0 �~08 �\, �Lp7
WATER HEATER 2 0 INDUSTRIAL r
WASTE APPROVAL
GAS SYSTEM OUTLETS 2 0 5 0 INSPECTION RECORD
OUTLETS OVER v
5 PER SYSTEM 30
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 ]UNDER
TOTAL FEE
r— APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant ��/y ��/f/�y�� SLAB WORK
Name ROUGH PLUMBING -3-7a~5�0, 9.)-7 auk
Address �� �� L
GAS PIPING
City Tel GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE REPPLICATION
AND STATE THAT THE ABOVE IS CORRECT ANTO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATEGULATING GAS TEST
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLYED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COSTATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNEINTEND TO
RESIDE IN THE ABOVE DESCRIBE RESIDENTIAL FINAL
SIGNATURE
OF PERMITTEE Ji
PERMIT VALIDATION cK M o �/�cnsH
PLAN CHECK VALIDATION CK M 0 CASH J �A A/y�)
( 3 7 1�JULi 10 5 ,017.0Y� � A. lb
0
S
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