HomeMy Public PortalAbout4331 1/2TEMPLE CITY BLVD_Plumbing (2) DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DIST:F NO GRWP I ZONE PERMIT
ArAR 1 EIVED BY READY FOR • OATEIBSUED
PLUMBER G FIRST I NSPECTION
ADDRESS �� vY �7 Tf� ? 6 116 —
CITY MPJ ' TEL NO {� ADDRESS �!
-COUNTY E
LIO <' EXPIR .�I yC ~�f �! LOCALITY CAL.+• �- �.rGiS/
NEAREST
MI•P C 6J
PERFEES CRO SST
U
NOMRER TYPE OF F[E M OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) 050 ADDRESS
BATH TUB O 00 CITY TEL NO
SHOWER O 50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATS THAT THE ABOVE 18 CORRECT AND
LAVATORY WASH BASIN O 50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O 50 STATE LAWS REGULATING PLUMBING
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNORYTUBORTRAY 0 O 50 ANGELES COUNTY ICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDENTI PROPERTY CRIBED ABOVE
GAB BYSTE O TLET9 O 50 SIGNATURE OF I /pr
WATER HEATER a O 50 PERMITTE
SLOPSINK a O 5 INSPECTION RECORD
FLOOR SINK 0 0 5
FLOOR DRAIN O 50 1
DISHWASHER 0 O 50
KINKING FOUNTAIN 0 050
URINAL go O 50 J
r HOUSE BEW ER 40 O 50 Z
MISCELLANEOUS _V'
E
O
APPROVALS
DATE INRFEROR• NAM%
ROUGH PLUMBING lak
GAS PIPING
GAS VENT
CESSPOOL loolool I CESSPOOL
SEPTIC TANK 8 DTIC TAN
DRAIN I ) PIT I ) ® 1 00 swwna
PERMIT t00 GAB TEST •rZ. J.L .c�'r wl0��
UTILITY CO NOTIFIED
TOTAL FEE • �� r '
�.� FINAL