HomeMy Public PortalAbout4443TEMPLE CITY BLVD_Plumbing (2) 76A.V7 (CE-BIT) - 5/79
APPLICATION FOR PLUMBING 'PE MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF. COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONBUILD ING
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MAKE CHECKS PAYABLE TO ADDRESS .7LL77L/3 T LE G� , 'B
HARVEY T BRANDT, COUNTY ENGINEER LOCALITY —7
FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEARE C to
ROSSST LOuJ fe ,S
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET- - 1 75 _ OWNER
~MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY a TEL NO
LAVATORY 1 75 CONTRACTOR a,,,_-/C r---L✓7_s /AE/eS
SINK y' 1 75 ADDRESS O
DISHWASHER 1 75 CITY --TZ�71PCe TEL NO
CLOTHES WASHER 1 75 STATE "pllLIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 75
PRO E55E BY
LAWN SPRINKLER SYSTEM 1 75 DISTRICT NO GROUP ELp`I•ALO Q y
WATER HEATER 1 75 yNgSTVE TA PAPPOVUAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD U
OUTLETS OVER 30 _ = o
5 PER SYSTEM
H-
� W
d
� Z
Plan check fee Se. R.",..
PLUMBING PERMIT ISSUING FEE $ 3 0l0,'
TOTAL FEE �`� APPROVALS DATE INSPECTOR S sirNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
CIty Tel No GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY OROINANCE6 AND STATE LAWS REGULATING
PLUM SI NG GAS TEST '
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR UTILITY CO NOTIFIED
LI CEMSED AS REOU I RED BT LOS ANGELES COUNTY AND STATE OF
CALI FG RNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDE TIAL PROP TY FINAL 14-41-7
r
SIGNATURE
OF PERMITTEE
PERMIT VALIDATIONcK 0 CASH
PLAN CHECK VALIDATION Cx M D CASH
556 1 5 0 •,J = 4.75A!s