HomeMy Public PortalAbout5043ALESSANDRO AVE_Plumbing (3) 76A667 (CE-817) - 5/73 ! ' / 7I.1 -m �c / 7y
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES fI
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: t ADDRESSC •�1it�C��O
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. G
NUMBER FIXTURE OR ITEM @ FEE
/ OWNER
WATER CLOSET 1.75
" MAIL /1 ,
BATH TUB 1.75 ADDRESS
SHOWER 1,75 CITY n TEL. NO.
LAVATORY 1,75 CONTRACTOR ��4 (
SINK 1.75 ADDRESS fL���(� �• l G!a/V(X�
DISHWASHER 1.75 CITY I� / TEL. NO. _IV 6
CLOTHES WASHER 1.75 STATE �S/ / qG� LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.75
DIS T N GROUP ONE CESSED BY
LAWN SPRINKLER SYSTEM 1.75 (f cf
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL a
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER 30 p
5 PER SYSTEM
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE vZ�
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 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES .. y
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED`
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAI, PROPERTY.
FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK: M.O. CASH
PLAN CHECK VALIDATION CK. M.0. CASH
2 1 G AK 17 5 0 82 5 hit-1,