HomeMy Public PortalAbout5611TEMPLE CITY BLVD_Plumbing (2) 76A667 - M17 5/70 -
City of .Temple City
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES n 14915
DEPARTMENT OF COUNTY ENGINEER aartDlNc
BULLDING AND SAFETY DAMON BUILDING
5611 No, Temple City Blvd.
JOHN A LAMBIE COUNTY ENa IN[[R
COLEMAN W JORKINS SUP T OP BUILDING LOCALl" m e Cit
FOR APPLICANT TO FILL IN PR NT OR TYPE
NEAREST
CROSSST
NUMBER FIXTURE OR ITEM EACH PEE
WATER CLOSET 1 50 OPmn N_ Nini_
BATHTUB ISO ADDRUS Same
SHOWER 1 50 CITY TEL NO
LAVATORY 1 50 C0WrRR OR GENERAL INSTALLATION CO.
SINK 1 so ADDRESS 6558 WEST BLVD.
DISHWASHER 150 CrrT Los Angeles TEL NO PL 32541
CLOTHES WASHER 150
STATE LIC
LICENSE NO C 36 151839 CU99
SWIMMING POOL RECEPTOR 3 50fReady
DISTRICT NO GROUP [ r Se[D SY
LAWN SPRINKLER SYSTEM 2 00 8 _ 1
WATER HEATER 1 50 1 WASTE�OVAL
GAS SYSTEM OUTLETS 150 INSPECTION RECORD VK^
OUTLETS PER SYSTEM R 30 forInspechon-Now n Z
WATER SOFTENER -moi
Plan check fee 21;% of above See reverse
PLUMBING PERMIT ISSUING FEE E
TOTAL FEE1"A�M.10:F
5
APPR0VAL9 DATE INEFccroR EEiGNATuq[
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel NoHOT WATER HEATER —
1 HERBST ACKNOWLEDGE THAT 1 HAY[ IIGO THAPPLICATION
ANO STATE THAT THE AOOY[ IE COKK[CT AND A0ELY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AMO STATE LAWING GAB TEST
PLUMBING
1 H[Ror CERTIFY THAT I AM FROFEELY REGIS /OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES CAUMTY OF
CALIFORNIA OR THAT 1 AM THE "GAL OWNER OF TOBESIDE IN THE YOYE D[KRIUD wES FINALSIGNATU R[ JACK R ALLEN, SU PEgvIaIN AMICAL ENG q
OF PERMITTER
PERMIT VALH)ATION CK M G CASH
PLAN CHECK VALIDATION CK M D CASH
i -
1 AC,9 4 9 113 PAR 9 .75 L'