HomeMy Public PortalAbout5332ALESSANDRO AVE_Plumbing 76A667 (CE 817) 4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING r.
MAKE CHECKS PAYABLE TO ADDRESS
HARVEY T BRANDT, COUNTY ENGINEER LOCALITY L - G Y
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST L I/
2 -L7 CK/L
WATER CLOSET 1 75 OWNER
MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY TEL NO
LAVATORY 1 75 CONTRACTOR /n
SINK 1 75 ADDRESS J ;2 (/
DISHWASHER 1 75 CITY J TEL NO
CLOTHES WASHER 1 75 STATE 9LJ LIC
SWIMMING POOL RECEPTOR 1 75 LICENSE NO / CLASS C 36
20
C
DISTRICT NO GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1 75
r
WATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD v
OUTLETS OVER 30 C
5 PER SYSTEM
F-
6)
W
a.
h
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
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
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NbTIFIED
LICENSED AS REOU I RED BY LO
5 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
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION CK M 0 CASH
PLAN CHECK VALIDATION
CK M o CASH
4363na OCT 20 5 D 4755-