HomeMy Public PortalAbout4815ALESSANDRO AVE_Plumbing (4) 76A667d ICE 81713) 9/75
APPLICATION FOR PLUMBING PERMIT
BUILDING A SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS TFJ �7 L
LOCALITY
WATER CLOSET
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL NOS. .4kgb
DISHWASHER CONTRACTOR l
S
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR ��/� r� .`�// 11
CITY �YCale� TEL N07Z�A\
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO �QZ CLASS
DISTRICT NO UP ZONE CESS D BY U
GAS SYSTEM 5 OUTLETS
OUTLETS OVER v F-
5 PER SYSTEMLLJ
INDUSTRIAL
WASTE APPROVAL 0-
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR 5 SIGNATURE
UNDER SLAB WORK
Address � jj Jw►�Cs ROUGH PLUMBING
City Ir f Tel NO ? � GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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 HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST `9
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATU RE �7
OF PERMITTEE FINAL
PLAN CHECK VAL ATION CK M 0 CASH PERMIT VALIDATION cK M O CASH
780 juN 2 5 ® 1 050 ♦�Ja
r
Q ��,