HomeMy Public PortalAbout4840TEMPLE CITY BLVD_Plumbing (2) 7CA667-CRAe17 SMI I
APPLICATION FOR `P` LUMSING PERMIT
COUNTY OF LOS ANGELES I
DEPARTMENT OF COUNTYDDENGINEER
B IIAG o DI�PBN= FM
ni�n� B�oGpD G
WILLIAM A JENSEN SUP T OP BUILDING IR1C
FOR APPLICANT TO FELL IN CENEAREST
NUMBER FIXTURE OR ITEM EACH FEE O
WATER CLOSET BI NAM
BATH TOR lfb
ADDHEES
SHOWER 1 CITY TEL NO
LAVATORY 1 CONTRACT
SDR 1 ADDRESS ,7
DISHWASHER 125 C TEL NO STAT/
ATE
LAUNDRY TUB 1 REGISTRATION NO Qa COUNTY
CLOTHES WASHER 1 DISTRICT NOL,OROU E R E B
WATER HEATER 150 ...- _ (t
r
GAS SYSTEM-OUTLETS-
150 WAASTE�PRAP OVAL O
OOTLEIS OVER 5 PER SYSTEM 50 DDIPECTION RECORD U
O
a
N
Z
APPROVALS DATE INSPECTOR a SIGNATURE
PERMIT f p OO UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HERESY ACKMOWLSDG[ THAT I HAV[ READ THIS APPLICATION GAS VENT
ANO RAT[ THAT TH[ ABOVE I[ CORRECT AND AOR[[ TO COMPLY
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
HOT WATER HEATER
PLUMBING
I HER[pY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS R[GUI REO LOS ANGEL[ COUNTY AND STATE OF GAS TEST
CALIFORHIA OR THAT A THE LEGAL N[R OF AND INTEND TO
R[SID[ IN THE Aro K R[SI TUL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERM ITT FINAL
0 C ROBERT A WOOD
m
cK M o u[H SUPERVISING MECHANICAL ENG R
JCO1 5 7 1% NOV 6 5D 3-50- v