HomeMy Public PortalAbout5836ALESSANDRO AVE_Plumbing 76A667C (CE 81713) 9/75
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN IPRINT OR TYPE) BUILDINZ-C
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR +
CLOTHES WASHER IT ' a t
ADDRESS OJQy.J
SWIMMING POOL RECEPTOR _
CITY TEL NO Y
LAWN SPRINKLER SYSTEM STAYIE
/ ATER HEATER (1o L CENSE NO ��J f� CILASS
DISTRICT NO GROUP Z9NE ESSEY
OCD BV
GAS SYSTEM OUTLETS )�/ 3 ^ C:)OUTLETS OVER 0 l� F-
5PER SYSTEM INDUSTRIAL w
WASTE APPROVAL d
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $ 4
TOTAL FEE 7 ,5_0
Plan check applicant
Name APPROVALS DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY TH AM PROPERLY ISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED OS ANGELES C Y AND STATE OF GAS TEST
CALIFORNIA OR THAT I E LEGAL OWN F AND INTEND TO
RESIDE IN THE ABOVE D CR BED RESIDENT UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE FINAL
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
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