HomeMy Public PortalAbout4852TEMPLE CITY BLVD_Plumbing (2) I �
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUIIING AND S}�FETY1VLSION BDILDLNG y
JO A LAMBIE OUNTY NGINEER
ADDHE88
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM EACH FEE CROSSr `
WATER CLOSET BI 75 OWN
ER
BATH TDB 175 ADDRESS
SHOWER 175 CITY TEL NO
LAVATORY 175 commcToa alley Plumbing Co
RDa 175 ADDRESS 44LZ W. Fleetwood Pl .
DISHWASHER 175 cr" Glendora TEL NOW 5—l2@F '
LAUNDRY TDR _ 1 u CONTRACTOR B '2094,'31 STATE
REGISTRATION NO COUNTY e
CLOTHES WASHER 175 OrrIDDTRICT jIO 6UP ZON!/ PRTAY
WATER HEATER 1 s0 J T' Q u
GAS SYSTEM OUTLETS 150 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER PER SYSTEM 70 INSPECTION RECORD S.
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A
DATE, INSmCjajR B wqdaew
PERMIT S 2 00 UNDE ORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
1 HEREBY ACKNOW"ODIE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND [TAT[ THAT THE ABOVE IE CORRECT AND AGME TO COMPLY
WITH A L COUNTY ORDINANCES AND STAT[ LAWS REGULATING HOT WATER HEATER
PLUMBING
I HSRov CERTIFY THAT I AM PROPERLY RK..STKsD AND/OR PLUMBING FIXTURES
LICANUD AS REQUIRED BY LOS ANGSLES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE UK AL OWNER OI AND INT[MO TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
ATION ROBERT A WOOD
cK M O 1 CASH SUPERVISING MECHANICAL ENG R
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