HomeMy Public PortalAbout4844ALESSANDRO AVE_Plumbing CE 817(REV 6/78) / /./- I/
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES _ BUILDING AND SAFETY
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FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING (��y l-//�
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NUMBER FIXTURE OR ITEM @FEE ADDRESS
1-2
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL
DISHWASHER FAUM VAL ERS
CLOTHES WASHER 4,MO Eo GRAM
M A y •
/E
SWIMMING POOL RECEPTOR ---TEMPLE Q1
l�/-���1 PS CA
QHE TEL NC(/gZ_ w7
LAWN SPRINKLER SYSTEM JATEp p
LIC
WATER HEATER O LICENSE NO �� /p CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
S PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
C9
HOT WATER HEATER I®
PLUMBING FIXTURES ()
GAS TEST _ m
t/1
Plan check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ ?} e
TOTAL FEE od FINALS
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Plan check applicant PLAN CHECK VALIDATION �
BOOR160�y�y
Name 6
Address
City Tel No
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE i
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 1 b 0 8 A
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
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I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE / O O 1 GOO 0
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL u
PROPERTY 0 0 0 1 Q 0 0 is
SIGNATURE 204-78
OF PERMITTEE � `ems��s:�-�L7��
DISTRICT NOOCESSED BY
INDUSTRIAL C•,C
WASTE APPROVAL