HomeMy Public PortalAbout5471TEMPLE CITY BLVD_Plumbing nmm n *a" m APPLICATION FOR PERM
DEPARTMENT OF BUMDING AND SAFETY 1
COUNTY OF LOS ANGELES PLUMBING
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICAr TO FILL IN DISTRICT NO GROUPZONE PERMIT NO
%- T ;0-/ 7�3.I )' 3
PLUMBER REC D BY READY FOR DATE 1 UED
ADDRESS FIRST I NSPECTION
7 i/ J7
DRES
CITY TEL -.61412 ADR®8
Coutrryl,
LOCALITY
LICENSE O IR
NEAREST
PERMIT FEES CR086 6T
NUMBER TYPE OF FIXTURE OR ITRM FEE OWNER
MAIL
WATER CLOSET (TOILET) O SO 0 1 ADDRESS
BATH TUB O SO CITY TEL NO
SHOWER a O so I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY WASH BASIN O BO THE APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O EO STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT 1 POSSESS ,TE ABOVE VALID LOS
LAUNDRY TUB OR TRAY ANI
THE LEGAL
O EO OPTHE RESIDENT) LICE
PRO E O IES M BED ABOVE OWNER
GAS SYSTEM/ OUTLETS FI O EO SIGNATURE OF
WATER HEATER ® OSO PERMITT6
SLOPSINK 0 O SO INSPEC ON RD
FLOOR SINK a O SO
FLOOR DRAIN 050
DISHWASHER O SOI
DRINKING FOUNTAIN O 60
URINAL O SO J
HOUSESEWER O SO Z
Z
MISCELLANEOUS V
0
O
I
I
I
APPROVALS•
DATE INRPEOTOR t NAME
ROUGH PLUMBING
GAS PIPING
GAB VENT
CESSPOOL 100 I a dp CESSPOOL I Y'
SEPTIC TANK SEPTIC TANK
DRAIN ( I PIT I I ® 100 SEWER
• PERMIT 100 GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE -1
FINAL VII �