HomeMy Public PortalAbout4815ALESSANDRO AVE_Plumbing 76A667 CE817 12159 TEMPLE E CITE'
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY ]DIVISION BUILDING
JOHN A LAMBI COUNTY NGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING
mkollamomm LOCALITY (�
FOR APPLICANT TO FILL IN NEARESCROST
Q
NUMBER FIXTURE OR ITEM
OWNE$
WATER CLOSET MAIL
BATH TUB ADDRESS
CTfY TEL NO
SHOWER
LAVATORY CONTRACTOR
SINS ADDRESS �(/ L
DISHWASHER CITYTEL NO
CON CTOR S STATE
LAUNDRY TUB REGISTRATION NO COUNTY
CLOTHES WASHER DISTRICT NO :rP orE BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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CA
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/ $1 0 PER REQ $ I /
r APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE /�{ f-J ROUGH PLUMBING
l GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE /J
OF PERMIT TE
— FINAL � aQ
or v VALIDATION ROBERT A WOOD
Cs m 0 CASH SUPERVISING MECHANICAL ENG R
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