HomeMy Public PortalAbout5428TEMPLE CITY BLVD_Plumbing (2) 76AG67aCES17 R 9
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER AD I
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
ST
NUMBER FIXTURE OR ITEM
OWNEH
WATER CLOSET
ADD
E58 I
-
BATH TUB q
SHOWER CITY • TEL NO ". g�/�J
LAVATORY CO OH a41
SINE ADDRESS
DISHWASHER CRY TEL NO d�'s
LARRY TUB CO R'S STATE LJ
REG N N OUNTT
CLOTHES WASHER
DISTRICT yD. GRO NE Ruor FOR IRSP[CTIon
WATER HEATER •i
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
® t1 DD PER REM DATE INSPECTOR S SIGNATURE
OR FIXTURE R UNDER SLAB WORK
PERMIT I 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY OS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I T E LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL foP
SIGNATURE
OF PERMITTEE FINAL
ROBERT A WO U
VALIDATION
SUPERVISING MECHANICAL ENG R
CF • 0
LG090OM MAY 15 3 A 2.00 SR
.r