HomeMy Public PortalAbout4929ALESSANDRO AVE_Plumbing (4) 7GA667 (CE 817) 1/75
j APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES `
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
MAKE CHECKS PAYABLE TO BUILDING !7
HARVEY T BRANDT COUNTY ENGINEER LOCALITY
PPLICANT TO FILL IN (PRINT OR TY PEI NEAREST
+ CROSS ST
F778ATH
FIXTURE OR ITEM @ FEE
2 00 OWNER
ER CLOSET MAIL
TUB ?,.COD 4-AA- 3 ADDRESS
SHOWER 2 00 CITY TEL NO
LAVATORY ao 2 ngcFe CONTRACTOR
SINK /= ADDRESS
DISHWASHER 200 v CITY TEL NO
CLOTHES WASHER 2 00 STATE LIC
SWIMMING POOL RECEPTOR r 2 00 LICENSE NO CLASS
DISTRICT NO GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER 2 00 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2 00 INSPECTION RECORD v
OUTLETS OVER
5 PER SYSTEM 30
O
H
U
W
CL
N
Z
Plan check fee See Reverse D
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE � 5�
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK 9
Name ROUGH PLUMBING
Address GAS PIPING
City Tel No GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
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 COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION cK M O CASH
PLAN CHECK VALIDATION CK M D CASH
5 1 3 PSEP 4 5 0 1 9 5 0 • n ,