HomeMy Public PortalAbout4820ALESSANDRO AVE_Plumbing (2) 76A667C ICE 9178) 9/75
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING rJ ', A
NUMBER FIXTURE OR ITEM @ FEE ADDRESS ` dALZ
!, LOCALITY
WATER CLOSET V
NEAREST
BATH TUB LCROSS ST ekj;Cioi.�-124
SHOWER o 0 OWNER
LAVATORYMAI L
t}(� ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO ;/-3r- t
LAWN SPRINKLER SYSTEM
STATELIC
WATER HEATER LICENSE NO v CLASS Dr
DISTRICT NO GROUPIZONE P OC ED BY O
GAS SYSTEM OUTLETS y.��' ,� C..')OUTLETS OVER , �r-�� 1 - / CD
O
5 PER SYSTEM C~7
INDUSTRIAL
WASTE APPROVAL fy
a.
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE Q
Plan check applicant
Name �a� ../i APPROVALS DATE INSPECTOR 5 SIGNATURE
UNDER SLAB WORK
Address dt ROUGH PLUMBING �s�7
City gz^-29=121 egirTel NO a` GAS PIPING
I HE BY KNOWLEDG AT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOW 15 CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATU RE
OF PERMITTEE FINAL rtl A&
PLAN CHECK VALIDATION CK M o cns PERMIT VALID TIO UKJ
o CASH
5��d 8,FEB 7 5 L) 1 350 &'t-