HomeMy Public PortalAbout4911ALESSANDRO AVE_Plumbing (A �v�♦
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
+a1 o�-FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING
ADDRESS
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER bd OWNER ,!f
MAIL
LAVATORY LTO ADDRESS
SINK Q CITY /e L NO
DISHWASHER CONTRACTOR
CLOTHES WASHER 3 eQ ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER 3 by LICENSE NO CLASS
GAS SYSTEM OUTLETS 3 crO OV LS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER alfB WORK 7 J7'dGGt!
5 PER SYSTEM ROUGH PLUMBING
r GAS PIPING
GAS VENT V
46
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST -!-0-fa
N
Plan check fee UTILITYCO NOTIFIED Z
PLUMBING PERMIT ISSUING FEE$ UI AMSMI— 7 �?o1�2GaWQt
TOTAL FEE FINAL -C e
d PLAN CHECK VALIDATION
Pion check applicant /7
Name
Address S f
City Tel No
1 HEREBY ACKNOWLEDGE TH I HAVE READ THIS APPLICATION AND STATE ;9-8 3 1 1 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION # O O 0 O O 5
1 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 2i0 O 2 C O/1
LEGAL OWNER OF AND INTE TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 5A V
PROPERTY
0 0 0 25,0 0 V
SIGNATURE
OF PERMITTEE 1 9-7 9
DISTRICT NO PROCESSED B
L.G
INDUSTRIAL
WASTE APPROVAL