HomeMy Public PortalAbout5615ALESSANDRO AVE_Plumbing r
76A667A
CE.817(REV 6/78)
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING A7 SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS
NUMBER FIXTURE OR ITEM @ FEE
LOCALITY
WATER CLOSET NEAREST /
BATH TUB CROSS ST [.,
SHOWER OWNERMAIL
f
l LAVATORY
ADDRESS—Z5&/-S
SINK CITYTEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
HOT WATER HEATER p®
PLUMBING FIXTURES (�
GAS TEST
Plan check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE — FINAL r _.✓
Plan check applicant PLAN CHECK VALIDATION
Name
Address
L
Tel No
EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
E LAWS REGULATING PLUMBING PERMIT VALIDATION -23864A
REBY CERTIFY THAT 1 ROPERLY REGISTERED AND/OR LICENSED AS
BY LOS ANGELES NTY ND STATE OF CALIFORNIA OR THAT I AM THE # O O O O O 5
NER OF AND INT ND TO SIDE IN THE BO DESCRIBED RESIDENTIAL
2 0 0 1300
RE MITTEE 0 0 0 1 30012,
DISTRICT O OCESS BY O 1 9'—7 9
INDUSTRIAL
WASTE APPROVAL