HomeMy Public PortalAbout5839ALESSANDRO AVE_Plumbing (2) A 667 - E 917 7-69
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APPLICATION F R PLU ING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FB
IIN JOHN A LAMBIE COUNTY ENGINEERCOLEMAN W JENKINS SUP T OF BUILDING IR
LITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) ESTS ST
NUMBER FIXTURE OR ITEM EACH FEE I
OWNER
WATER CLOSET 1 50 MAIL
BATH TUB1 50 ADDRESS
SHOWER 1 50 CITY TEL NO
LAVATORY 1 50
CONTRACTOR
SINK 1 50
ADDRESS
r
DISHWASHER 1 50 CITY TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50 DISTRICT NO GROUP ZONE R C SEP BY
LAWN SPRINKLER SYSTEM 2 00 3
WATER HEATER 1 50 INDUSTRIAL O
WASTE APPROVAL �
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD
OUTLETS OVER j O
5 PER SYSTEM 30 r
V
� N
z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE S 00
TOTAL FEE
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING -N
Address I GAS PIPING
GAS VENT
City Tel NO 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 GAS TEST
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ORI UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OM�Z
RESIDE IN THE OVE 7DWED RESIDEN IAL PR FINAL C'
SIGNATURE JACK R ALLEN, SUP R ISIN HANICAL ENG R 4
OF PERMITTEE i
PERMIT VALIDA N cK M o CASH
PLAN CHECK VALIDATON CK M o CASH
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�1� 4,75- n'
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