HomeMy Public PortalAbout5019ALESSANDRO AVE_Plumbing (2) 76 A#667—CE 8 17.8/68
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS Or
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY G,
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST. �.Z
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY TEL. NO-5:3-V-2--
LAVATORY
O.5: —2--LAVATORY 1.s 0 CONTRACTOR
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GRO ... ZONE I PIN Y
LAWN SPRINKLER SYSTEM 2.00 '� O a
111 CD
,WATER HEATER 1.50 INDUSTRIAL U
WASTE APPROVAL o
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD 2
OUTLETS OVER
U
_ 5 PER SYSTEM .30
rn
Z
Plan check fee 2S% of above. See reverse.
PLUMBING PERMIT ISSUING FEF, S 2 00
TOTAL FEE .�
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION 41
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/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 PROPEWY.,f FINAL
SIGNATURE ` �i/ �V�/,f
OF
PERMISIGNATURE
000���>LLL'fi�G/ •W" JACK R. ALLEN, SUFERVI,SING CHANICAL-ENG'R.
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH