HomeMy Public PortalAbout4940TEMPLE CITY BLVD_Plumbing APPLICATION FOR PLUMBING PERMIT 1
DOB n 1broi ION OF B=DFG AND SAFETY
Department of County Engineer
County Of I.oe Angelm BUILDING
JOHN A L.AMBIE COUNTY ENGINEER ADDRESS /
CASSATT D,GRIFFIN,SUP T Or BUILDINo
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS BT
OWNER D O DISTRICT No GROUP. I ZONE I READY roR IxsPILn DR
MAIL Sq
ADDRESS
INDUSTRIAL
CITY L NO WASTEAPPROVAL
PLUA1elR INSPECTION RECORD
ADDRESS
.—�� y
CITY NO
LICENSE NO
NUMBUR TYPE OF FIXTURE OR ITRM FEE
WATER CLOSET (TOILET) a $1 00 S
BATH TUB $1 00
SHOWER 81 00
ti
LAVATORY (WASH BASIN) @ jl 00
KITCHEN SINK $1 00
DISHWASHER $1 00
LAUNDRY TUB OR TRAY $100
CLOTHES WASHER @ $1 00
WATER HEATER $1 00
GAS SYSTEM Q 1 00
APPROVALS
DATE INSPECTOR SSIGNATURE
LD/OR
NDER SLAB WORK
PERMIT $ OUGH PLUMBING 2 S
AS PIPING
TOTAL FEE
GASVENT
I HEREBY ACKNOW:THAT
THAT I HAVE READ THIS APHOT WATER HEATER
AND STATS THAT THS CORRECT AND AGREE E
WITH ALL COUNTY ES AND STATE LAWS RELUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFYAY PROPERLY R GISTEREAB TESTLICENSED AS REQUIRS ANGELES C N CALIFORNIA OR THAE A TILITY CO NOTIFIEDDESCRIBED RESIDENT
SIGNATURE
OF PERMITTEE INAL
JOHN A LAMBW 6OUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
■ S CASH
X07 6 0 8 APR 2 6 3 300 n