HomeMy Public PortalAbout4430TEMPLE CITY BLVD_Plumbing (2) 'lMbbl GYR 17 II-Bn APPLICATION FOR PERMIT
DEPARTMENT OFLNG AND SAFETY PLUMBING
COIINTY LOS ANGELES
WIlL1AM J.. FF LOS FOX, OHIcr ENa1NCER
FOR APPLICANT TO FILL IN DISTRICT NO. ORULIP(:S;-- R 10/ S Q
PLUM B[R C [IV[D By READY FOR DAT[ 1[D
FIRBTINBP[CTION _ l�lr
ADORERS E �
t wLo1NGLV
CITY ` TEL No (f ADDR[BR
COUNTY LOCALITY G `
LICENSE NO EXPIRES
NEAREST
P� FEES CROBBR7 L /.
NUMBER TY/[�O.,F[LFlfRXi1LlR[LOq�-mm RD
F[[ OWNER C b C
MAIL
1 WATER CLOSET(T'OIL[T) @ Dan S
ADDRESS 41 ei 1 v0,
BATH TUB @ can CITY X A TEL No
SHOWER @ Mao I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH RABIN) @ O BO APPLICATION AND STAT[ THAT THE ABOVE IB OORREDT
ANDAOR[[ TO COMPLY WITH ALL COUNTY ORDINANCCB
KITCHEN SINK @ can AND STAT[ LAWB REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY @ O BO AMG[LM COUNTY LIO[NBE. OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL ROP[RTY ERCRIB D ABOVL
GAS SYSTEM uTLKTB @ O BO SIGNATURE OF
WATER HEATER @ 050 PERMIT"
GLOP BINK @ O 60INS#kCTION RECORD
FLOOR BINK @ O.BO
FLOOR DRAIN @ Dan •O 51
DISHWASHER @ D.BO �✓ ��
DRINKING FOUNTAIN @ Dec
URINAL @ ago J
a
HOUSE SEWER @ MSG Z
MIBCELLANEOUB 0
R
O
I
APPROVALS
OAT[ IMBF[BTOB•B NAM[
ROUGH PLUMBING '—
GAS PIPING
GAB VENT
CESSPOOL @ IaO CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( I @ 1 OO SEWER I
PERMIT 110 GAB TEST 12
UTILITY CO.NOTIFIED
TOTAL FEE B 6
FINAL