HomeMy Public PortalAbout4333TEMPLE CITY BLVD_Plumbing (2) 761667 - M17-5/70
APPLICATION FOR PLUMBING' PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION AD�" 3 3
1 JOHN A L.AMBIE. COUNTY ENoiN[ER
COLEMAN W.JENKINS SUP T of BUILDING LGCALIiT
FOR APPLICANT TO FILL IN PR PTT OR TYP NEARCROEST
T 611
NUMBER FIXTURE OR ITEM EACH FE[
OWNER
WATER CLOSET 1 � /
BATH TUB 1 ADDEl8p8.�'7` -5
SHOWER I CITY V NO
LAVATORY 1 CONTRACTOR - � ,
SINK I ADD 6
DISHWASHER I 0 O N�S6 y
CLOTHES WASHER 1 0 STATE LIC a'
LICENSE NO ZZ CLASS
SWIMMING POOL RECEPTOR 40 Z R
LAWN SPRINKLER SYSTEM 2 -Trap17-0
P [SY Y
y
WATER HEATER t 0 D ASTE 111l��OY p,
�6<�7
GAS SYSTEM OUTLETS 1 0 ON RECO8
RD
OUTLETS OVER
5 PER SYSTEM 0 b 'fes Z
O
11 !r
t Q
rn
G(� 4E f441 Z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE S 00
TOTAL FEE
APPROVALS ATEIM ECT [OMATUMC
Plan check applicant UNDER SLAB WORK 001-77-,
Nagle ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER
1 N[IQY[ IQ
LY ACRM"MCN3[ THAT 1 HAW TNI[ ARLI4TIOM
AND [TAT[ THAT TH[ A[OY[ I[ CO[I4R AND AOIRL TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY OIUNMANQ[ AND "AT[ "W[ MODUTINa GAB TEST
I H[ROY CZW'rY THAT I AM FIID MLY WOI[nIQD AND/OR UTILITY CO NOTIFIED
LIC[M[[O Al IROUIMO [Y LW ANa[L[[ COUNTY ArID [TAT[ OF
=: ONON T 1 AM TN[ LEGAL OWNZR OF A HR[ND To A 17
ID[MIMIA KMK R[ID[Nn FINAL Q z
RlanwTLRE JACK R ALLEN, 3UPERVI ONE CH ANICU.A.H OF FFRMITTE[
PERMIT VALWATlO CK me
PLAN CHECK VALIDATION CK M o CA3H
3 -5 `V;S FEB 9 D $.7 eJ
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