HomeMy Public PortalAbout5319TEMPLE CITY BLVD_Plumbing 78AE67-CE817-11-57 N
APPLICATION FOR PLUMBING •PERMIT
COUNTY OF LOS ANGELES 1 1
DEPARTMENT OF COUNTY ENGIIEM
BUILDING AND SAFETY DIVISION BOD.DwG
oma A. LAELBIE, Cermt� Paaln.Rr
ADDRESS 3/
A GRlpPIN, env QI mdn,o
LOCALITY'
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM
S ST
WATER CLOSET OWNER
MAIL
BATS TOB DRESS /
SHOWER CIT �-Z e, TEL No 3G/
LAVATORY CONTRACTOR
smx ADDRESS AU
DISHWAEEM CITY TEL NO
LAUNDRY Tot UNTRA B
REGISTRATION NO COUNTY
CLOTHES WASHER DISTRICT NO GROUP }}ZO�NE ARADY MR HISPICTIGR
WATER HEATER T
GAS BYRTEW' INDUSTRIAL
WASTE APPROVAL
INSPECTION ORD
APPROVALS
®
ON F KT TTENI / _ DATE INSPECTOR S SIGNATURE
�N 0 PER rr K / UNDER SLAB WORK
PERIL IT f 00 ROUGH PLUMBING
TOTAL FEE OAS PIPING tr .( I
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 6ASVENT QI AY
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER /'T
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
1 HEREBT CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
1p
DESCRIBED RKSIDENTIAL PROPERTY /1
FINAL
ROBERTA WOOD
mP
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