HomeMy Public PortalAbout4855TEMPLE CITY BLVD_Plumbing (2) 7$AG6T•C ESSIT 4E4
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUI IIQCSAFETY �IVISION IAIDDDRP88 T o ee
JO A I COUNTY NGIN[!R
WILLIAM A JENSEN SUI T OF BUILDING LOCALITY G
FOR APPLICANT TO FOS IN C
NUMBER FIXTURE OR ITEM EACH FIE
OWNER Al
WATER CLOSE[ 91 23 �¢
BATH TITS 115 ADDRP88
HO
SHOWER 125 r� CRT TEL ,.
LAVATORY Its J CONTRA
SME 123 ADDRESS
DISHWASHER 123 CRY TEL HO
LAUNDRY TOB 123 CONTRACTOR13 STATE B
REGISTRATION NO COUNTY
CLOTHES WASHER 125 DISTRICT NO GROUP ZONE PROCESSED BY
t WATER HEATER 150 Q `OUAf
I /?'�
GAS SYSTEM-OUTLETS-
ISO INDTRIAL
WASTE APPROVAL O
OUTLETS OVER 3 PER SYSTEM 30 IMPECTION RECORD V
K
O
a
H
Z
APPROVALS DAT! INSPECTOR SIGNATURE
PERMIT i 2 OO UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE TNAT THE ASOvE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY Y ORDIMANCES AND RATE LAWS REGULATING HOT WATER HEATER
nUMEINO
I H[R®v CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES
LICKNMO AS INQUIRED BY LOS ANGELES COUNTY AND STATE OF
GLIIMMIA OR THAT I AY THE LEGAL OWM[R OF AND INTEND TO GAS TEST
RUIOR IN THE MOv[O[ RI IO[ L PROPERTY UTILITY CO NOTIFIED r
SIGNATURE
OF PERMITTEE
FINAL�7
VALIDATION ROBERT A WOOD
CK M O CMH SUPERVISING MECHANICAL ENG R
LACp 6 5 2 2-w DEC 2 8 5 D 5.7 5- 4