HomeMy Public PortalAbout4912TEMPLE CITY BLVD_Plumbing 7eAa67w lac et7el tTna(.N���,{-1G�� CA, 11
APPLICATION FOR PL M B ING RM IT 1i
READY FOR FINAL INSPECTIO
BUILDING AND SAFETY DIVISION
FORAPPLICANTTO FILL IN(PRINT OR TYPEI BUILDING
NUMBER FIXTURE OR ITEM O FEE ADDR
5v 17,11
WATER CLOSE I LOCAL(
BATH TUB NEAREST
CROSS ff
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL
DISHWASHERE%lWtbC I NST/-LL W RS
CLOTHES WASHER 10920 E. GRAND iNE
SWIMMING POOL RECEPTOR TEMPLE rITY f -" f TEL N ofsI
-707
LAWN SPRINKLER SYSTEM
STATE LIC
WATERHEATER OO LICENSE CLASS
GAASSLSEYSSTEEyMF� OUTLETS DISTRI _'E
UP ESSE BY yy
55 SOP
YSTEM INDUSTRIAL r 3
WASTE APPROVAL O
INSPECTION RECORD V
O
d
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan Check applicant
Name APPROVALS DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE MAD THIS APPLICATION AND STATE GAS VENT
THAI THE ABOVE IS CORRECT AND AGREE TO COMPLY WRX ALL COUNTY ORDINANCES
AMD STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR LICENSED AS PLUMBING FIXTURES
REOUIRED BY LOS ANGELES COUNTY AND STATE OF C ORHIA OR THAT I AM THE GAS TEST
LEGAL OWMER OF AND INTEND TO RESIDE IN THE"ME DESCRIBED RESIDENTULL
PROPERTY UTILITY CO NOTIFIED
SIGNATURE -J
OF PE RM I.Eze4LP 11�L o�rrii FINAL
1.1
PLAN CHECK VALIDATION�ATION .. 3ii;0F SF4AWIOSAT.1O PERMIT VALIDATION cK 1 ro CASH
POLICY HOLDER: 1 3 6 ntiAR i i 5 0 1 0.0 0 A�3
POLICY NUMBER: �,.�