HomeMy Public PortalAbout5029TEMPLE CITY BLVD_Plumbing 7SA567 ACE-5171- 5/73
APPLICATION OR PLU BING PERMIT
COUNTY OF LOS ANGELES LJ
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 7DRE
Q M1fAKE CHECKS PAYABLE TO / /HARVEY T BRANDT, COUNTY ENGINEER .�/I�IFOR APPLICANT TO FILL IN (PRINT OR TYPEI NUMBER FIXTURE OR ITEM @ FEEWATER CLOSETBATH TUB 1 75
SHOWER 1#75
CITY L NO
LAVATORY 1 CONTRACTOR . /
SINK 1 ADDRESS
DISHWASHER 1 75 .CITY, TEL NO�' 8,-3
CLOTHES WASHER 1 75 STATE n LIC A
LICENSE NO z¢ CLASS L'
SWIMMING POOL RECEPTOR 1 75
)IST NO GROUP NE PR ESSE Y
LAWN SPRINKLER SYSTEM 1 75 . 0 's
D � f
WATER HEATER 1 75 WASTE APPROVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD
OUTLETS VER
5 PER SYSTEM 30 CC
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t
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N
Z
Plan check fee S.. R.Y.,..
PLUMBING PERMIT ISSUING FEE S 3 11 00
TOTAL FEE
APPROVALS DATE FHB ve on v 5IfN1T RE
Plan check applicant UNDERSLAB WORK
Name ROUGH PLUMBING _
Address GAS PIPING
City Tel No GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING r
PLUMBING GAS TEST '
I HEREBY CERTIFY THAT I AM PROPERLY REOISTEREO D/OR UTILITY CO NOTIFIED
LI CEM SED AS RED UI REO LOS AN SS COUNTY AND OF
CALI Ip RNIA OR THAT I AM THE L OWNER.D AND T TO
RESIDE IN THE AEON D SC ISEO IDEMTI ROPERTY INAL
SIONAI RE
OF PERMITTEE ,
PERMIT VALIDATION CK M o CASH
PLAN CHECK V ATION CK M 0 CA 4 ZP 7 5 0 82 5 A7jb