HomeMy Public PortalAbout5214TEMPLE CITY BLVD_Plumbing (2) �' Ynr•ss ^ •a• m APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
z WILLIAM J FOX. CHIEF ENGINEER
FOR APPLICANT
,TO/FILL IN DISTRICT NO GROUP
P ZO % PERMIT NO
PLUMBER 1 I !� 'V I if RECEISVED BY READY FOR DATE IISSUUED,
11[[,� }}�� 1' FIRST INSPECTION -/4'�
ADDRESS41 O SO U94 OF I E4-b {� U
l BUILDING
CITY 1 TE N ZLLV� ADDRESS 1
COUNTY
O
LICENSE NO � V p( IR &I ao-:1 I LOCALITY � e,1
NEAREST 6 Z 'Z- Sv
PEHNIIT FEES CROSS ST
MuM![R TYF[OF F!rn R[OR IT[M FE[ OWNER o 5t L N
1 MAIL
WATER CLOSET (TOILET) O EO • AD DREGS
I
BATH TUB O BO CITY TEL NO
SHOWER O EO 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY WASH BASIN 1 O EO APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN BINK O EO STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 POE•HSS THE ABOVE VALID LOS
LAUNDRY TUB TRAY O EO ANGBL® COUNTY LIC NSQ OR I AM THE LEGAL OWNER
OF THE REBIDQNTI ROP RIB[D/ABOVE
GAS SYSTEM OUTLETS O EO I OF
WATER HEATER O SO SIGNATURE PHRMITTH
SLOPSINK O 501 #14ECTION RECORD
FLOOR 9INK O 60
RLOOR DRAIN O EO
DISHWASHER O SOI
DRINKING FOUNTAIN FD O EO
URINAL O EO J
HOUSUSEWER O SO z
MISCELLANEOUS
0:
� i I
T I
I
I
APPROVALS
DATE IMN[LTOR t MAUL
ROUGH PLUMOING
GAS PIPING
GAB VENT
CESSPOOL 1 CESSPOOL
PFFEER!MICT
ANK SEPTIC TANK
N ( ) PIT ( ) ® 1 00 SEWER
1 00 GAS TEST
UTILITY CO NOTIFIED
TAL FEE •
V FINAL