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Home My Public Portal About5036ALESSANDRO AVE_Plumbing 76A667A n / CE 8171REV 8/781 ©5 APPLICATION FOR PLUMBING PERMIT co;;- ' " " 1�0P Lbs r-D& ANAL ffUtl�a `iA ETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST K SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY TEL NO DISHWASHER CONT A R'F 01 CLOTHES WASHER ADDR10920 SWIMMING POOL RECEPTOR CITY T L Q LAWN SPRINKLER SYSTEM _ STATE UA L WATER HEATER LICENSE NO / rff ASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES CA GAS TEST 6� Plan check fee UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ e TOTAL FEEFINAL 46g A 59 Plan check applicant PLAN CHECK VALIDATION Name Address City Tel No IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 23 1 3 9 A THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING I PERMIT VALIDATION # 00000rj 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELE TE OF CALIFORNIA OR THAT I AM THE 2 a a 1 Q O O LEGAL OWNER OF AND END TO RESIDE IN BOVE DESCRIBED RESIDENTIAL P aaa1000� SIT URE Z Z OFPE E 0a,09— r9 DISTRICT NO PRO ED BY INDUSTRIAL WASTE APPROVAL o 0