HomeMy Public PortalAbout5223ALESSANDRO AVE_Plumbing (3) -r
76A667 - CE817 7-69
I
I
V APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FAE
BUILDING AND SAFETY DMSION JOHN A LAMBIE COUNTY ENGINEER 522.3 AlpgsgricirnCOLEMAN W JENKINS SUP T OF BUILDING "Yemple City
FOR APPLICANT TO FILL IN (PR NT OR TYPE) Blackley
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 1 50 Robert B 1
MAIL
BATH TUB 1 50 ADDRESS 5223 Alessandro
SHOWER 1 50 CITY Temple City TEL No 2 --00
LAVATORY 150 CONTRACTOR Pacific Tnsta llrs
SINK 1 50 ADDRESS 10920 Grand Ave.
DISHWASHER 150 CITY Temple City TEL NO 442--7070
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO 211898 CLASS
SWIMMING POOL RECEPTOR 15 DISTRICT NO GRO P ZD{E P D BY
LAWN SPRINKLER SYSTEM 2 00 /�'✓
WATER HEATER 1 50 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 150 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30 Q
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Plan check fee 2S% of above See reverse
PLUMBING PERMIT ISSUING FEE 9 2 00
TOTAL FEE Q
APPROVALS DATE INSPECTOR SSIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER t
1 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
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE L:RIWT.NAL
ER OF AND INTEND TO
RESIDE IN THE ABOVE CRI D PROPERTY FINAL
SIGNATURE JACK R ALLEN SUPERVISING CHANICAL ENG R
OF PERMITTEE
PERMIT VALIDATION cK M o CASH
PLAN CHECK VALIDATION CK M o CASH
L eD 73 5 69 OCT 2 7 ' 5 0 3,50-
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LA
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