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HomeMy Public PortalAbout5029TEMPLE CITY BLVD_Plumbing (2) 7BA667 (CE-617) - 5/75 APPLICATION FOR PLUMBING- PERMIT" COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TOn1, T ADDRES BUILDING > �T f E HARVEY T BRANDT, COUNTY ENGINEER _ LOCALITY3 FOR APPLICANT TO FILL IN (PRINT OR TYPEI NEAREST CROSS ST _ NUMBER FIXTURE OR ITEM O FEE WATER CLOSET 1 75 4 I OWNERAIL BATH TUB 1 75 ADDRESS SHOWER 1 75 CITY r 1~TEL NO- LAVATORY i 75 CONTBACTO QO 7 SINK 1 75 ADDRESS DISHWASHER 1 75 RO11 Y CITY 11j 0 TEL NO FI �r 11 CLOTHES WASHER 1 75 _ IIS STATE' LIC SWIMMING POOL RECEPTOR 1 75 LICENSE•NO 31c CLASS DIS_TRIv Ng GR UP MINE CESSEO BY LAWN SPRINKLER SYSTEM 1 75 I 5gg �pI L �7 WATER HEATER 1 75 IND TAPAPROVAL WAS GAS 5 E O 1 75 - -MPECIIONAWCORD c� OU ET VER 5 TEM 3O 1 p D LIA y I Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR S SIGNATURE Plan Check applicant DER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City _ Tel No GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCE! AND STATE LAWS REUULATINO PLUMBING GAS TEST I HEREBY CERTIFY T AM PROPERLY GISTERED AMD/OR UTILITY CO NOTIFIED LICENSED AS REOUIRI BY OS •N S EL LS C TY AND STATE OF CALIFORNIA OR THAT NE LEGAL OW F. AND INTEND TO RESIDE IM THE ADDY IB RlBIOE ROPERTY FINAL SIONATU RE OF PERM E PERMIT VALIDATION (CK 0 CASH PLAN CHECK VALIDATION CK M 0 Cu"6 5w$EP 11 5 4_ .7 5 A96 , i