HomeMy Public PortalAbout4846TEMPLE CITY BLVD_Plumbing (2) 70,,f16WrCEB0I7 10.63 �'�x V
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APPLICATION FOR P UMBING HERMIT Illl
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDnEss
H IIQG � SAFETY DIVISION
JO A LAM�IE COUNTY ENGINEER M c D
WILLIAM A JENSEN WP T OF BUILDING LOCALITY £&/ E
FOB APPLICANT TO FDS IN ca�OSS BY
NUMBER FIXTURE OR ITEM EACH FEE OWNS
WATER CLOSES Sim MAO.
BATH TOB 1 25 ADDRESS Jd/D
SHOWER 175 CITY C ry TRL NO
LAVATORY 125 CONTRACTOR
SINL 125 ADDRESS — Sj� S
DISHWASHER 175 Cm TEL No), L
LAUNDRY TSIR 175 aCS � COUNTYSTATE
REGISTRATION No /O 3/
CLOTHES WASHER 175 mDISTRICT NO GR UP Ni OCEBSED BY
WATER HEATER ISO
OAS SYSTEMS OUTLETS 1 SO INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM SO - II18PECTION RECORD V
�� ua K'til 0
AP OVALS ,DATE INBPEcrop a slaNA_
PERMIT 5 2 00 UNDERd=rd WORK
ROUGH PLUMBING 8�
TOTAL FEE
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE la CORRECT AND AGREN TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATS LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HERS\Y, CERTIFY THAT 1 AM PROMBLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LE pAL OWME OF NO INTEND TO
RUIDE IN THE ABOVE SCRIe[D ID[Nr UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL ��i
ANON ROBERT A WOOD
' cK M o CASH SUPERVISING MECHANICAL ENG R
LiC,05068w- OCT 20' 5 D 5,75-