HomeMy Public PortalAbout5623ALESSANDRO AVE_Plumbing (5) 76A667A ICE 6178) 11/76 3 0 a rLL
Ad APPLICATI®I
910
U M B ING PER 1T
OR FI AL INSPECT
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BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING, n A r
NUMBER FIXTURE OR ITEM ® FEE ADDRESS 1�J l ) W y���_f 1�
WATER CLOSET LOCALITYNEAREST
BATH TUB CROSS ST ow-,
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SHOWER OWNER �N S
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LAVATORY MAIL
ADDRESS I7'l
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SINKCITY TEL NO 60
DISHWASHER CONT Thr-Ill op.
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CLOTHES WASHER ADD S INSTALLERs
SWIMMING POOL RECEPTOR
CITY G,'?�AJrpIrt
LAWN SPRINKLER SYSTEM STA CIC
WATER HEATER \ LICENSE NO 1,G CLASS
GAS SYSTEM OUTLETS DISTRICT NO GROUP ZONE] P CESSE�D AV
OUTLETS OVER 7 o8 � / 8r/ ,S
5 PER SYSTEM INDUSTRIAL
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Plan check fee
PLUMBING PERMIT ISSUING FEE$ 0
TOTAL FEE
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Plan check applicant
APPROVALS DATE INSPECTOR S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING �r
City Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER
AND STATE LAWS REGULATING PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS
PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST ~�+
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 7
PROPERTY UTILITYCO NOTIFIED 6
SIGNATURE
OF PERMITTEE — ` - FINAL
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