HomeMy Public PortalAbout4819TEMPLE CITY BLVD_Plumbing 7BA867•CEBI7 ILIQ
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BD¢DDta
OHN A LAEEB" CermIT ADDRESS 4,,p/.f
�/ T N /f Ci
Cl rT D 6aIPPaT. BIw t d B �`W4.7 LOCALRq
FOR APPLICANT SO FILL IIv NEARECROSSSTc,A,e r R JeyfA A61V o/
NUMBER FIXTURE OR ITEM OTFNEB D�`A� M.LrA$fY
WATER CLOBET NAM
RATE TUB ADDRESS
CRY TEL NO.
SHOWER
CONTBACTOR •,�,r ,/; Ci o fl f�/mss
LAVATOar :
Baa ADDg= W. l.w. dt.
WMETWASHEIH CWT.41*A Aw'do,A. TEL NO.c'oz?
RBTATE CONTRA e <C-3i) coulm
LAUNDRY TUB CTRA R /SNO O?/d
CLOTEMR WASHER DISTRICTNO GROUP ZONE CE88£D B ,
WATER HEATER
GAS BYarm INDUSTRIAL
WASTE APPROVAL
/r/dor �f'.;v.(� U93PECTION RECORD o
/ a OIIDDPIi Sfa s /, o 0
APPROVALS DATE INSPECTOR JSIGNATURE
PERMIT f E 00 UNDER SLAB WORK
TOTAL FEE ., o o ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF GAB TEST
OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESID PROPERTY ,UTILITY CO NOTIFIED
SIGNATURE
OP PERMITTER
FINAL
mF OVAMATIM ROBERT A WOOD.
OS.
IS G. CASE SUPERVISING MXCHANICAL EN(rR
1-Pto5 2 2 s S FEB 9 5 A 3.00 :9