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HomeMy Public PortalAbout5126TEMPLE CITY BLVD_Plumbing rl PLUMBING 1 .. atmAxT�Nr of 000itrrY ErTanNEee 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