HomeMy Public PortalAbout5223ALESSANDRO AVE_Plumbing -7 —CE 817 8/68
i
APPLICATION FOR PLUMBING PERMMT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEA
ING
JOHN A. LAMBIE, COUNTY ENGINEER ESS5223 *11oaawidre
COLEMAN W. JENKINS. SUPT. OF BUILDING LITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) S ST._ r`
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50 £ ',/;, MAIL
BATH TUBI ADDRESS 5-223 AlessanAre
SHOWER 1. 0 t CITY ti TEL. NO.
LAVATORY 1.50 'CONTRACTOR
SINK 1.50 ADDRESS
4265 • buidwirt Ave.
DISHWASHER 1.50 CITY , TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LItENSE NO. CLAS
SWIMMING POOL RECEPTOR. 1.50Y
'DISTRICT NO. GROUP ZONE tROCESSED BY Q-
LAWN SPRINKLER SYSTEM 2.00 - �- '�— .'� je, �F-. .,� CD U
WATER HEATER 1.50 INDUSTRIAL = �
WASTE APPROVAL L�
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM .30 p
Lu
+ L
Plan check fee 2S-1 of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FETE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
Ci[p Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL 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,AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE ,� •'• �, ? JACK R. ALLEN, SUPERVISING MECHANICAL ENG—R.
OF PERMITTEE,
PERMIT VALIDATION '''CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH »