HomeMy Public PortalAbout5126TEMPLE CITY BLVD_Plumbing (2) >awea> n e-aa ® APPLICATION FOR PERMIT
f DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICTNO. GROUP ZONE PERMIT NO.
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS
BUILDING
CITY /"l STEL. NO. AODR ESS
COUNTY LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) 0.50 ADDRESS
BATHTUB @ 0.50 CITY TEL. NO.
SHOWER @ 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR"1 AM THE LEGAL OWNER
OF THE RESIDENTIAL CRI CRI ED ABOVE-
GAS SYSTEM---3—OUTLETS @ 0.50 SIGNATURE OF
WATER HEATER @ 0.50 PERMITTEE' - ����
SLOP SINK @ O.So INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50 I
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 ,J
HOUSESEWER @ 0.50 Z
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MISCELLANEOUS U'
K
0
APPROVALS
DATE INSPECTOR'9 NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT f ) @ 1.00 SEWER
PERMIT 1,00 GAS TEST
TOTAL FEE $
UTILITY CO. NOTIFIED
L/1- �✓ FINAL y