HomeMy Public PortalAbout5438TEMPLE CITY BLVD_Plumbing (2) 777 W °"°O ® APPLICATION FOR PERICT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTgCT NO O P ZONE 3780 PERMIT0 NO
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PLUMBER Sc RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION Fj s�
ADDRESS SAN S / — � ~•
BUILDING
CITY No ADDRESS
COUNTY LOCALITY
CH O L IDIP
NHARHHT
PE MT FEES CROSSST
NUMBER TYPE OF FI%TORE OR ITEMFEE OWNER
MAIL 50
WATER CLOSET TOILET O SO ADDR688
BATH TUB a O EO CITY TEL NO
SHOWER O SO 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY WASH BASIN O SOAPPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O SO STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOG
LAUNDRY TUB OR TRAY O SOANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDQN AL PROPERTY DESCRI VQ
GAB SYSTEM-OUTLETS a O SO /J
12� SIGNATURE OF C:
WATER HEATER O SO 11
PCRMITTH
SLOP SINK O 60 INSPECTION RECORD
FLOOR SINK O EO
2 S ri
FLOOR DRAIN O SO
DISHWASHER O SO ��✓� TEST'• / ��
DRINKING FOUNTAIN 050 L,ar c'r� OC
URINAL O SO �.,.�� ,J
HOUSE SEWER O SO `
Z
MISCELLANNOUS C9
0 K
O
APPROVALS
DATE MEPKC R• NAME
ROUGH PLUMBING
GAS PIPING w i` sw L'�Bi✓
GAB VENT r
CESSPOOL a 100 CESSPOOL
SEPTIC TANK SRPTIC TANK
DRAIN ( ) PIT ( ) ® I ool SEWER
PERMIT t 00 aA6 iQBT ✓
TOTAL FEE
UTILITY CO NOTIFIED
6 f FINAL
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