HomeMy Public PortalAbout4449TEMPLE CITY BLVD_Plumbing 78A887—CE 8174!1
APPLICATION FOR PLUMBING RERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENG94M rADMDRZ5SDwa
BUILDING AND SAFETY DIVISION Ic�[�yt Q
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING AFOR APPLICANT TO FILL IN PRNT OR TYPE BS
NUMBER FIXTURE OR ITEM EACH FEEia
WATER CLOSET 130
BATH TUB 150 ADDRFAA J 7-1)
SHOWER 150 CnT TSL NO v
1-falpso
LAVATORY 150 CONTRACTOR
SINE 150 ADDRIM
DISHWASHER 150 CRT a TEL NO tjP6 -
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO (o v CLASS � 6
SWIMMING POOL RECEPTOR 150 DISTRICT NO GROUP ZONE PROCNE ED BY
LAWN SPRINKLER SYSTEM 2 00 ��' _Z �� /}�[
WATER HEATER 150 0 INDUSTIRM V
WASTE APPROVAL Z
GAS SYSTEM UTLETS 1 50 DRSPRCTION CORD O
5 PERSOUTLETS 30 AV9rC
5 PER SYSTEMTEM �.
IT
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE
APPROVALS DATE INYECTOR S SIGNATURE
Plat) Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City lei No HOT WATER HEATER
I HEIOT ACNNOWLEOOE THAT 1 HAVE RGO THIS APPLICATION
AND RATS THAT THS /JOYS IS CONVECT AND AORQ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCSS AND STAT[ CAWS 11[DULATINo GASTEST
PLUNBIHo
I H[R[SY C[ N [ R[
RPY THAT I AN PROPRLY OISr{RSM
D AD/OR UTILITY CO NOTIFIED
LIQNSED A[ aoulR[D BY Lw ANo[LE[ COUNTY AND STATS Or
CALIFORNIA OR THAT I AM THE L[OAL OWN[R OF AND INTEND TO
MAIM IN THE ABOVE D[ECRIE[D SIMWIAL PROP[RTT FINAL t
SIGNATURE
JACK R ALLEN, SUPERVISING HANICAL ENO R
OF PERM ITT!E44 x
PERWIP VALIDATION M o CASH
PLAN CHECK VALIDATION CH MV0 CASH
~ �r 6 3 6 91�1 FEB1 1 5 0 350— q