HomeMy Public PortalAbout5476TEMPLE CITY BLVD_Plumbing (2) "Xew vy °-w APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY' PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DIST�ZT
NO GROUP ZONE 1" 3 JLC lZMITj`!O
PLUMBER R!QlIVF BY READY U
FI$Yi4NYP[CTION
ADDRESS Q 4t3
JE Af gAd /M 11
,. �{ BUILDING
CITY M6N+i' TEL NO ADDRESS
COUNTY
LICENSE NO "FIRM LOCALITY
NEAREST `
PERMIT £EES CROSSST
NUMGi11 TYPE OF FIITUM OR IT K FEE OWNER CO
MAIL
WATER CLOSET TOILET O BO 111 ADDRESS
BATH TUB a O 00 CITY TEL NO
SHOWER O EO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY IWASH BASIN O BO APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK O 80 STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 POMESS THE ABOVE VALID LOG
LAUNDRY TUB OR TRAY O BO ANGELES COUNTY LICENSE OR 1 AM THE LBL AOWNER
OF THE REGIDEN PROPERTY D CRISCO Ay
GAB SYSTEM OUTLETS ® O to Or V
WATER HEATER 0 s OIGNATURE PERMITTE U�LF W Rto
SLOP SINK o Bo INSPECTION RECORD
FLOORSINK O BO
FLOOR DRAIN 050
DISHWASHER 0 BO
DRINKING FOUNTAIN @ O 50
URINAL o BO
HOUSESEWER O BOIra Z
MISCELLANEOUS 19
4
APPROVALS
DAT[ �INEFECTOR O HAMi
ROUGH PLUMBING
GAB PIPING
^, GAB VENT
CESSPOOL 1 00 U CESSPOOL t
SEPTIC TANK SEPTIC TANK i
DRAIN ( ) PIT I ) ® 1 DO SEWER
PERMIT 1 OO GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE S /
FINAL