HomeMy Public PortalAbout5951ALESSANDRO AVE_Plumbing (5) �-
7.r,A.167 (CE 817) B 71 � .��
APPLICATION FOR PLUMBING PER
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADIORES$ `(/ /� y
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM @ FEE OWNER
WATER CLOSET 1 75
MAIL
BATH TUB 1 75 ADDRESSV
/ SHOWER 1 75 , CITY t9 7 TEL NO2—P 7"L
LAVATORY 1 75 CONTRACTOR
SINK 1 75 ADDRESS
DISHWASHER 1 75 CITY TEL NO
CLOTHES WASHER 1 75 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 75
DIST ICT NO GROUP Z NE P CE D 8Y
LAWN SPRINKLER SYSTEM 1 75 ` O Q
WATER HEATER 1 75 INDUSTRIAL 0.
WASTE APPROVAL G
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD V
OUTLETS OVER 30 i z
5 PER SYSTEM G
H
U
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Plan check fee See reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE f
APPROVALS DAT I ECTOR J1 §,lGNATURE
Plan check applicant UNDER SLAB WORK 2
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
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 I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESSCRRIIBjD REESSSIIDEENNTIAL /R�OPFTY FINAL
SIGNATURE �_ '"' T/_ /! (J"✓ L/ /
OF PERMIT TEE. !/
PERMIT VALIDATION DI --Vy CASH
i
PLAN CHECK AL/IDATION C M O CASH
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