HomeMy Public PortalAbout4920ALESSANDRO AVE_Plumbing (3) 76A607 CE817 10 60
APPLICATION FOR PLUMBING PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS Q Q �F y
WILLIAM A JENSEN SUP T OF BUILDING
LOCALiTY��,�l�c
FOR APPLICANT TO FELL IN NEARESCROS4 T - P-
NUMBER FIXTURE OR ITEM
oAIL F I-",
WATER CLOSET ��
BATH TUB ADDRESW9
CITY GetCt v TEL. NO T^
SHOWER
CONTRACTOR i[
LAVATORY
SINS
ADDRESS
DISHWASHER CITY TEL NO
CONTRACTORS LAUNDRY TUB REGISTRATION NO COUNTY
CLOTHES WASHER DISTRICT igQi GROUP i ZONE R 8
WATER HEATER o
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD f /' a
o
r -
(�
$100 PER ITEM
OR FIRTURE $ / APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 1 2100 UNDER SLAB WORK
TOTAL FEE /�n ROUGH PLUMBING
!i v GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
i HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL OPERTY UTILITY CO NOTIFIED /
SIGNATUREf
OF PERMITT `
FINAL
VAI. ROBERT A ,WOOD
M 0
CK m o /�cnaH SUPERVISING MECHANICAL ENG R
r 1
G' U 0 T ? 5 D 300
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