HomeMy Public PortalAbout5703ALESSANDRO AVE_Plumbing (4) 76A667 CE*817 10 67
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APPLICATION FOR PLUMBING PERIIv
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
UI DR IN
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING LOCALITY P�� �TY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST _
NUMBER FIXTURE OR ITEM EACH FEE T
OWNER
WATER CLOSET 1 50
MAIL
BATH TUB 1 50 ADDRESS
SHOWER 1 50 CITY TEL N
LAVATORY 1 50 CONTRACTOR /�Y,�)Ravl +'s"
SINK 1 50 ADDRESS �T-
DISHWASHER 1 50 CITY CQ v� O,:93* as
CLOTHES WASHER 1 50 STATE o LIC
LICENSE NO fbda�3 CLASS
SWIMMING POOL RECEPTOR 1 50 DISTRICT NO GROPP ZONE PR
,QeVSS5p BY
LAWN SPRINKLER SYSTEM 2 00 .{{ D_
U
WATER HEATER 150 INDUSTRIAL
/ WASTE APPROVAL O
GAS SYSTEM OUTLETS 1 So s O INSPECTION RECORD V
OUTLETS OVER W
5 PER SYSTEM 30
Z
Plan check fee 2S% of above See reverse
PLUMBING PERMIT ISSUING FEE $ 2 00
TOTAL FEE ,SO
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel NO HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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
I 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 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABO DEGCRIBED RESIDENTIAL PROPERTY FINAL
SIGNATURE J
OF PERMI T JACK R ALLEN SUP RVISI HANICAL ENG R
PERMIT VALIDATION c K M O C ASH _1
PLAN CHECK VkADATION CK M o CASH
tAr, 12- 2 aI JtL30 - 5 D 3 50N�"�