HomeMy Public PortalAbout5126TEMPLE CITY BLVD_Plumbing rl PLUMBING 1
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DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
OOUNTY OF LOS ANGET.ES eu1LDINa
WILLIAM L FOX, COUNTY ENGINEER 'ADDRESS _l
FOR APPLICANT TO FILL IN LOCALITY
BUILDINGMEARE8T
ADDRESS L Al. CROSS ST
DISTRICT NO G 2 E PERMIT NO
LOCALITY S .7
NEARE8T
CRO88 BT RR///SSS////CCC,'/E�1p/y-)E�DjBj{�y ROAOT for InSpwVu DATE ISSUED
_OWNER "—
MAIL INDUSTRIAL
ADDRESS & OVAL
CITY TEL NO INSPECTION RECORD
PLUMBER
ADDRESS
CITY TEL NO
❑STATE
LICENSE NO ❑COUNTY J
PERMIT FEES =
4UMO[R "PC Or FI%1YP[ OR mm FC[
WATER CLOSET(TOILET) a 0 M 8
O
BATHTUB 0 080
SHOWER a 080
LAVATORY(WASH BASIN) a 080
KITCHEN SINK 0 080
LAUNDRY TUB OR TRAY ® 080
SLOP BINK ® ago
FLOORSINK a 080
FLOORDRAIN a 080
DISHWASHER a 080
DRINKING FOUNTAIN O 080
URINAL a 080
GASSYSTEM .L_ _OUTLETS 0 IAO
WATER HEATER 0 100
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER BLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE OAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE HEAD THIS APPLI OAS VENT
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNT GAB TEST d
AND STATE OF CALIFORNIA OR THAT 1 M THE LEGAL 0
ER OF THE ABOVE ESCRIBED�QRESID L PROPERTY UTILITY CO NOTIFIED
SIGNATURE wW1i"0 /'
OF PERMITTEE G !!loan _ _
FINAL Ito IQ S+(
MAA DRS 11 a b 14.33