HomeMy Public PortalAbout4930ALESSANDRO AVE_Plumbing 75 A 667 - CE 817 7-69
APPLICATION FOR PLUMBING P RMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION F
GJOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS SUP T OF BUILDING YFOR APPLICANT TO FILL IN (PR NT OR TYPE) Lower Azusa Rd•
T
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
1 WATER CLOSET 1 50
Audrey j . King
BATH TUB 1 50
DDRESS 4930 Alessandro Ave.
SHOWER 150 CITY Temple Cit TEL N0287-4176
1 LAVATORY 150 0 CONTRACTOR
SINK 1 50 ADDRESS
DISHWASHER 1 50 CITY N TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50 DIST ICT NO GBaLIP .��..iiiQQQjjjJJJ
LAWN SPRINKLER SYSTEM 2 00 97O� ,J `✓ SED BY
1 WATER HEATER 1 50 INDUSTRIAL �, / }(
WASTE APPROVAL �J
GAS SYSTEM OUTLETS 1 50 0 i INSPECTION RECORD
OUTLETS OVER / �1 Q
5 PER SYSTEM 30 (/ r/�/����r?mss` �,r/,�cs �//}�/� �/�..fI✓G
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Plan check fee 2S% of above See reverse
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE
APPROVALS DATE ^SPECT074S SIGNATURE
Plan check applicant Audrey J . King UNDER SLAB WORK
Name Audrey
ROUGH PLUMBING
Address
4930 Alessandro Ave• GAS PIPING
GAS VENT
City Tem le City Tel NO HOT WATER HEATER ./ g� G��//►r �,,�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION PLUMBING FIXTURES
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY a w......
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST it
PLUMBING
1 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 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROP — FINAL
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SIGNATURE JACK R ALLEN SUPERVISING MECHANICA
OF PERMITTEE if
PERMIT VALIDATION CK M O C ASH
PLAN CHECK VALIDATION CK M o VCASH
5 1'9 71=2 AN 3 D 9.5 O t a V
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