HomeMy Public PortalAbout4303TEMPLE CITY BLVD_Plumbing TEMPLE CRTY
TeweeT CE#6171 ea
i A PLICATION FOR (PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF OAF COUNTY ENGINEER
BU FNi t BUILDING
Miele COUNTY NalFETY 'NS�°N ADDRESS H3 / /
WILLIAM A JENSEN SUP T OF BUILDING LOCALR'Y
9
FOR APPLICANT TO FDS IN cNEAREST
BOW ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER C
WATER CLOSET $125KAM
_
HATH TDB 125 ADDRESS `7my �l c �Nf A 05
SHOWER 125 C� O AC TEL NO
c
LAVATORY ISS CONTRACTOR
SDI[ 125 ADDRESS JAI
L
DISHWASHER 1 25 '
CITY Q -L SII. NO o V y
LAUNDRY TUR 121 REGISTRATION NO y COUNTY
CLOTHEH WASHER 125 DISTRICT NO GROUP ZONE p SEED By
WATER HEATER 150 O /' Z
GAS SYSTEM OUTLETS 150 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER RTSTEM 50 INSPECTION RECORD >~
u
Dc
Ft 3 IL
N
-- Z
APPROVALS ATE INv cTOR•SIGH _
PERMIT s 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I M[R[er ACRNowI[DO[ THAT I NAV[ RUD TRI[ wITLIui1oN GAS VENT
AND STAT[ THAT THE AROV[ I[ CORRECT AND AORU TO COMPLY
WITH ALL COUNTY ORDINANCE AND [TAT[ LAW[ MOULATINO AN r
PLUMBING HOT WATER HEATER �j
1 H[Rmr CERTIFY THAT I AM FROP[RLY REGISTERED AND/00 PLUMBING FIXTURESul)WF !
LICEMRm A[ =QUIRID OT LO[ AN06L6B COUNTY AND RAT[ OF GAS TEST
CALIFORNIA OR THAT 1 A L[ OWNER OF AND IMT[MO TO
R[l'0%IN THE/JO Ot RI SI NTIAL PIIOP[IT' UTILITY CO NOTIFIED
SIGNATURE
OF PERMIT_ FINAL
ALIDATION ROqfERT A WOOD
cK M o c,uH SUPERVISING MECHANICAL ENO R
J8 4 1 Oto FEB 9 5 D 5.75-' a
i2f��rFl./