HomeMy Public PortalAbout5516TEMPLE CITY BLVD_Plumbing (2) 7e 7AICII•tTel 11/76
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE BUILDING
5516 Temple City Blvd
NUMBER FIXTURE OR ITEM O FEE
WATER CLOSET, LOCALITY Kemple City
BATH TUB NEAREST
cRosssr BroadWa
SHOWER OWNER Schaub, Tom
uvAroRr ADDRESS 5526 Temple City;1 B&vd
SINK CITY TR TEL NO qPr,_
DISHWASHER CONTRACTOR W. E. Graham
CLOTHES WASHER
. ADDRESS 9127 Las Tunas Drive
SWIMMING POOL RECEPTOR
CITYTRmp1s City TEL NO r
LAWN SPRINKLER SYSTEM
WATERHEATER replace STATE
ENO 104466 LIC C-36
GAS SYSTEM OUTLETS DISTRICT NO GROUP ZONE BY
C72 06
O$PER$YSTEMR INDUSTRIAL
WASTE APPROVAL 000
INSPECTION RECORD Y ,
W
d
Plan check fee
PLUMBING PERMIT ISSUING FEE E
TOTAL FEE 7 5D
Plan check OPPIKonr
Nome , APPROVALS DATE INSPECTOR S SWNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
CITY Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALLCOUNTY ORDINANCES
AND STATE uLNS IIEGULATING PLUMIONG HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES y
WOVIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE UESCIDSED RESIDENTW.
PROPERTY UTILITYCO NOTIFIED
SM3NATURE
OF PERMTTTE FINAL
PLAN CHECK VALIDATION CK M o CASH a (�F�A�T iID@j�pN TS p cK, AID CASH
7.5 0 ams
JAW. es