HomeMy Public PortalAbout5043ALESSANDRO AVE_Plumbing 76A667 - CE817 5/70 �/� (t•� /c _ ^�� ��%
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEAREST
JOHN A. LAMBIE, COUNTY ENGINEER (�
COLEMAN W. JENKINS. SUPT. OF BUILDING
FOR APPLICANT TO FILL IN (PR NT OR TYPE) .
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNERGZ—
�
MAIL
BATH TUB 1.50 ADDRESS z
SHOWER 1,50 CITY TEL. NO.
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY /- �r- TEL. NO. /�/ -
CLOTHES WASHER 1.50 STATE /� LIC
LICENSE NO. i CLASS
SWIMMING POOL RECEPTOR 1.50
DIS�TR'^ICT NO. Grp ZON P OCESS BY
LAWN SPRINKLER SYSTEM 2.00 U Gf
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 / INSP CTION RECORDIIIJJJ
OUTLETS OVER If
5 PER SYSTEM p 30 /7 r
7
g
Plan check fee 25% of above. See reverse. —
PLUMBING PERMIT ISSUING FEE .9 1 100
TOTAL FEE 1j Q
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
Cit GAS VENT
y Tel. No.
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
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 I AM THE LEGAL OWNER OF,A INTEND TO
711 SIDERESIDE IN,THE ABOVERETIAL PROP Y. FINAL
SIGNATURE
OF PERMITTEE JACK R. ALLEN, SUPERVIS4 M ANICAL ENG'R.
I In PERMIT VALIDATIO CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.0. CASH
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