HomeMy Public PortalAbout4851ALESSANDRO AVE_Plumbing (3) 76A667A
CE 817(REV 11/78)
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
=FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
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NUMBER FIXTURE OR ITEM ® FEE
LOCALITY
WATER CLOSET
NEAREST
BATH TUB 49 CROSS ST
SHOWER 0 W N E R
LAVATORY
ADDRESS V fflF
SINK CITY `t TEL NO •r-J/ 1
DISHWASHER CONTRACTOR�����
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY f l�/ C/. TEL NO 72,14 ftV
LAWN SPRINKLER SYSTEM JATE
LIC
WATER HEATER LICENSE NQ-21��= CLASS 7J�y
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
C116
GAS PIPING A
u
GAS VENT cc
HOT WATER HEATER 0-
PLUMBING FIXTURES Y
GAS TEST �Y1
Plan check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ n
TOTAL FEE FINAL
Plan check applicant �iPLAN CHECK VALIDATION U
Name ��"�
Address
City Tel No
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION 2023 1 A
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 O O o5
LEGAL OWNER OF AND INTEND RESPE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY 2/O 1 000
SIGNATURE 0 0 0 1 0 0 0
OF PERMITTE
DISTRICT NO ROCtESSED BY 0506-80
INDUSTRIAL \
WASTE APPROVAL
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