HomeMy Public PortalAbout5232TEMPLE CITY BLVD_Plumbing (2) 7SA 667--'CE�617 7.69
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APPLICATION FOR PLUMBING �P IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BDnDwc
BUILDING AND SAFETY DIVISION ADDAFSS '�
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCAIJTY G /
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FOR APPLICANT TO FILL IN PR NT OR TYPE C0o88 9T
NUMBER FIXTURE OR ITEM EACH FEE
OWNER C
WATER CLOSET 150 MAU.
HATH TUR 150
SHOWER 1 50 CITY TEL NO -,r,6-
LAVATORY 150 CONTRACTOR
SINK 1 50 ADDRESS
DISHWASHER 1 50 CITY TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50 DI[TRICT NO �GUP� N{ PR EO BY
LAWN SPRINKLER SYSTEM 1 00 SQ 1 I
WATER HEATER 150DUS OVAL
GAS SYSTEM OUTLETS 150 / U INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM 30
Plan check fee 29a of above See reverse
PLUMBING PERMIT ISSUING FEE E 2 00
TOTAL FEE d
APPROVAL.H GATE IH6HCTOR a SIGNATURE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
GILY Tel No HOT WATER HEATER
I N[RmT ACK11""00[ THAT 1 HAV[ NICAD WIN ARLICATION
AND "AM THAT TH[ A[OV[ I[ coaN[cT AND AOR[[ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY WOINANC[[ w110 [TwT[ uw[ RauuTING GAS TEST
PLUMING
1 H[I®T C[RTIFT THAT 1 AN PIIOP[RLY IRa1R[QO AND/OII UTILITY CO NOTIFIED
LIC[NKD A[ R[OUIRID [T LO[ ANG[L[[ COUNTY AND [TAT[ OF
CALIFORNIA ON THAT 1 AM TN[ L[OAL OWN[N OF AND IMT[NO TO
RIA11M IN THE AW D[[CRIUD R[[m[NTIAL F NTY FINAL
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL a R
OF P[RMITT[[
PERMIT VALIDATION CK M o GE
PLAN CHECK VALIDATION CK M o CASH
I e[`_ a l a 1R MUR20 5 D 350