HomeMy Public PortalAbout5343TEMPLE CITY BLVD_Plumbing 76 7 ME 17 7-51
APPLICATION FOR PERIM
DEPARTMENT OFNG AND SAFETY
COUNTY LOS ANGELES
WILLIAM J.OF
LOS FOX, CHIS► ENGINEER PLUMBING 1
FOR APPLI FILL IN Z(o/jQ
PLUMBER v— 0RKCEIYTO PY FIRBTINBPEOTIDN DAT 1 [D
APPREM S
IL
CITY T[L NO ADDRESS
CDu
.1.1132m bill V LOCALrrY
NEAREST
PERM T FEHB ORDSBSr
MYMwDV TY/[or rllliYw[ow ITOI ME OWNER
MAIL
WATER CLOSET(TOILE" • O SO S ADOR[BB '�
BATH TV B @ ago CITY 79L. No
SHCWER • O.Bo 1 N[R[SY ACKNCWL[DO[ THAT 1 HAVE READ THIS
LAVATORY (WASH SABI N) @ O 60
1IATIONTHE AMOVE 113 CORRECT
A1
LASR[[ TO UM Y WITHSTATEA ALL COUNTY ORDINANCES
KITCHEN BINK @ 050 AND STAT[ LAMS R[CULATINO PLUMBING.
1 CERTIFY THAT 1 POSSEBS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY • O So ANCO,[S COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
BAB SYBTKM CUTLETS • ago OF THE R[BID[NTI OPERTY D IB[D OVE.
SIGNATURE DIF,
WATER MEATIER • O w PERMIT?[
SLOP BINK • ago INMMCT1611
RECDRD
FLOOR BINK @ O Bo
FLOOR DRAIN • ago
0111HWASH[R • ago
DRINKING FOUNTAIN • ago
URINAL • O 60 Q
HOUR[ SEWER • 030 Z_
MISOELLAN[OUS
G
APPROVALS
DATE IN0P[ R Y NAM[
ROUBH PLUMBING
BAB PIPING
SAB VENT
C[SOPOOL @ / OD CESSPOOL Ce 2
8[PT10 TANK1 SEPTIC TANK
GRAIN ( PIT ( ) • I OO SEWER I -374
PERMIT I DO BAB TEST
�O UTILITY o0 NOTIFIED
TOTAL FEE a2
FINAL