HomeMy Public PortalAbout5025TEMPLE CITY BLVD_Plumbing 76 17 DBs 19 11-50 APPLICATION FOR PERF=
�. DEPARTMENT OF RUnMING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOg APP NT ILL IN DIBTRIUT NU .LIKUUP ZONE PERMIT a 3 2- � .
PLUMBER - READY FOR p� ��
RCO SY FIpRTINBPECTION j(- T[ U[D--
ADDRESS �
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COUNTY -a 7 -�,_ LOCALITY
NEAREST
PERMIT FEES Cone BY
HUMMER TYK OF II%TIRE an RSM FEE OWNER
Al-'r2IAl
MAIL
WATER CLOSET(TOILET) @ O s0 B ADDRESS
I BATH TUB @ O s0 CITY TEL NO
SHOWER @ 050 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WABH BASIN) @ O SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND ASR[[ TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN RINK @ 050 AND STAT[ LAWS REGULATING PLUMBING
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
LAUNDRY TUB O TRAY @ O 50 ANGELES COUNTY LICENSE, OR 1 AM THE L[
0A8 RYRTEN OUTLETS @ DSO
or THE RESIDENT'A OP[RTY BE E.
SIGNATURE O�
I WATER HEATER @ 050 PBlM1T7f Q-'
GLOP BINK @ G BO INSPECTION RECORD
FLOOR BINK @ O SO
FLOOR DRAIN @ 050 - 1�
DISHWASHER @ O s0
DRINKING FOUNTAIN @ O SO T'C
URINAL @ 050
a
HOUSE SEWER @ D.SO , I !jQPp. Z
MISCELLANEO
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APPROVALS
DATE I"8M=OR•w NAM[
ROUGH PLUMBING
OAS PIPING Ze
OAB VENT vzl�
CESSPOOL @ 1 m CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1 mI SEWER
PERMIT I 1 m BAB TEST
UTILITY CO NOTIFIED Y
TOTAL FEE IB
FINAL