HomeMy Public PortalAbout4809ALESSANDRO AVE_Plumbing (2) z` k
S`
001
76 A 667 - CE 817 7-69
�r AP_I,PLICATION FOR PLUMBING PERM
COUNTY OF LOS ANGELES
z 11 �
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING v �£�
JOHN A LAMBIE COUNTY ENGINEER ADDRESS T
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY 1,12
NEAREST
FOR APPLICANT TO FILL IN (PR NT OR TYPE) CROSS ST Q
NUMBER FIXTURE OR ITEM EACH FEE �
owNER
C'
WATER s o >B
WATER CLOSET 1 SO
MAIL
BATH TUB 150 ADDRESS $
SHOWER 1 50 CITY rG TEL NO,,�
LAVATORY 1 50 CONTRACTOR
SINK 1 50 ADDRESS
DISHWASHER 150 CITY TEL NO I
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50 DiSTRI Nq GRO ZONE I PRO E6 BY
LAWN SPRINKLER SYSTEM 2 00 Glp'
WATER HEATER 1 50 INDUSTRIAL pp�� O
_ WASTE APPROVAL
GAS SYSTEM OUTLETS 1 50 V INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30 J !�
O
i V
a Q
z
l
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE $ 22 00
TOTAL FEE J APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING `
GAS VENT
City Tel No
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCE. AND STATE LAWS REGULATING GAS TEST 7
PLUMBING
IHEREBY 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 D CRIBED RESIDENTIAL Y FINAL
SIGNATURE 1IT//Tifj-�� JACK R ALLEN SUPERVISING MECHANICAL
OF PERMITT ,}
PERMIT VALIDATION CK M o CASH „
PLAN CHECK VALIDATION CK M o CASH
8 1,0 7c-- DEC22 5 D 3.50-
a _