HomeMy Public PortalAbout4914ALESSANDRO AVE_Plumbing 76A667 (CE 817) 1/75 C I `
APPLICATION FOR PLUMBING PERMIT
' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO ADDRESS
HARVEY T BRANDT, COUNTY ENGINEER
LOCALITY ("Z--
FOR APPLICANT TO FILL IN (PRINT OR TYPE) CNEAREST
ROSS ST
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 200 OO OWNER all
�Z 1
MAIL
BATH TUB 200 ADDRESS - (
t / SHOWER 2 00 0 CITY -� TEL NO
A
r LAVATORY 2 00 ,l CONTRACTOR
SINK 2 00 V ADDRESS
Z
DISHWASHER 2 00 CITY TEL NO
CLOTHES WASHER 2 00 3 4 t) STATE LIC
SWIMMING POOL RECEPTOR 2 00 LICENSE NO CLASS
LAWN SPRINKLER SYSTEM 2 00 DISTRICT NO GROUPJ %E RO SSED BY
WATER HEATER 2 00 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2 00
INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30457tC� U
O
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U
W
CL
C-0
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ ap
TOTAL FEE -V
APPROVALS DATE INSPECTOR 9 SIGNATURE
Plan check applicant UNDER SLAB WORK f�
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUN AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWN F 1 AN?.
TO
RESIDE IN THE ABOVE DESCRI DRE D NTI RO R�TY FINAL
SIGNA TU RE
OF PERMITTEE �
PERMIT VALIDATI E1 N cK o cnsH
PLAN CHECK VALIDATION CK M o CASH t
08 0 TAY 2 5 5 D 1 9 5 0 m,�