Loading...
HomeMy Public PortalAbout4840TEMPLE CITY BLVD_Plumbing TBA,. A (CE ,rTAPPLICATION FOR PLUMBING PERMIT BUIL-DING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUDRII /� /t NUMBER FIXTURE OR ITEM • FEE T `- WATER CLOSET LOCALITY t BATH TUB NEAREST CROSSST Llwlr SHOWER OWNER 171ek MAIL LAVATORY ADDRESS k (i& IfIlez SINK CITY `. C TEL NO a DISHWASHER CONTRACTOR d �4i/ fr CLOTHES WASHER ADDRESS 417 121 SWIMMING POOL RECEPTOR OAT a tvbw.w TEL Na LIC- LAWN SPRINKLER SYSTEM �j�j(` Q' WATER HEATER LICENSE NO J J ✓ 1/` CLASS Of GAS SYSTEM OUTLETS tGASVENT ISTRICT NO P ON D 8 U(TT pp EE D 55 PER$YSTFMR INDUSTRIAL O d - _I TE APPROVAL y INSPECTION RECORD EDD W d L7 Plan check fee PLUMBING PERMIT ISSUING FEE S TOTAL FEE Plan check applicantName APPROVAL$ DATE INSPECTOR S SM:IUNRE ER SLAB WORK AddressGH PLUMBING City Te PIPINGI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND VENTTHAT THEABOVEIS CORRECT AND AGREE TO COMPLY W H ALL COUNTY ORDINAND STATE LAWS REGULATING PLUMBING WATER HEATER IHEREBYCERTFYTHAT1AM PROPERLY REGISTERED AMD/ON UCENSMBING FIXTURESREWIRED BY LOS ANGELES COUNTY AND STATE OP CALIFORNIA OR THAT I ATESTLEGAL OWNEN OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIOEPROPERTY ITYCO NOTIFIED SIGNATURE OF PERMITTEE L PLAN L.OMC NAp ATc&QN PERMIT VALIDATION <i No CAIN POLICY HOLDER: 2 3 6 AUG 10 5 D 1 0.0 0 ,&ga POLICY NUMBER: