HomeMy Public PortalAbout4430TEMPLE CITY BLVD_Plumbing -ewes} c#IT E e1 TEMPLE CETY
• ' APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER eDILDI1a
JUMGLSAFETY DIVISION wnRPJse y(t�30 /�� GST Ll/
JO A M I COUNTY ENGINEER
WILLIAM A JENSEN SUPT OF BUILDING LOCALITY L
FOR APPLICANT TO FDS IN c�Ros�e MST O t j/5 tg
NUMBER FIXTURE OR ITEM EACH FEE OWNLB _ LA
- - WATER CLOSET 1125
MAIL
BATH TOR ,u ORE98 3 O T LF Lf
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BHowEH 1 u clrr yoG rEL No
LAVATORY 145 CONTRACTOR b
SNR 145 ADDRESS
DISHWASHER 145 CRT TEL NO
LAUNDRY TUR 1 45 CONTRACTOR H STATE e
REGISTRATION NO COUNTY
CLOTHES WASHER 145 DISTRICT OR I NE E
WATER HEATER 150
GAS SYSTEM OUTLETS 150 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 40
INSPECTION RECORD a
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APPROVALS DATE INSPECTOR[elan kw
PERMIT S 2 OO UNDER SLAB WORK /
ROUGH PLUMBING 1 _
TOTAL FEE GAS PIPING
1 HEIMMY ACKNOWLEDGE THAT 1 NAV[ R[AO THIS wRL1uY Ox GAS VENT / ~
ANO fTwT[ THAT THE ABOVE IS CORRECT ANO AGR[[ TO COMPLY
W ATI ALL COUNTY ORDIMANCES AHO FIAT[ "WE R[OuuTINO HOT WATER HEATER
MUNISING
1 H[nESY C[RIIFY THAT 1 AM PROPERLY REGISTERED Ax0/OR PLUMBING FIXTURES
LI
CZ=D AS REQUIRED RY LOS ANGELES COUNTY AND 51-1- Ol GA6 TEST
CALIFORNIA OR THAT I AM THE LEOAL OWNER OF AND INTEND TO
R[SID[ IN THE ABOVE OEECKIEEDAR[SIOEMTIAL PROPERTY UTILITY CO NOTIFIED .`��
SIGNATURE
OF PERMITYEE y
FINAL �f
VAMATT ROBERT w6OD
ON I M O cwSN SUPERVISING MECHANICAL ENG R
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