HomeMy Public PortalAbout5619-5619 1/2-5621-5621 1/2TEMPLE CITY BLVD_Plumbing 7S?U3V-M17-BSE -
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGRNCER
BUILDING G ANDRSAFETtYY DIMON ow
G{88ATT A.D cmlP M�4 Rf Hmalep LOCALITY
FOR APPLICANT TO FILL IN RO
NUMBER FIXTURE OR ITEM
OWRES
WATER CLOSET 1®R
RA,ffi TUB ADDSM
mow= CITY TEL N
LAVATORT COIITSACTOS _
MNK Am= �
DISHWABffi CTTT
CONTRACTOR Is MATZ u
LAOHDRT TOB REGISTRATION NO t, COUIRT
CLOTHES WASH DISTRICT NO GNPUP ONE ED BY
WATER HRA=
OAS SYSTEK EOlOBTmRL
WASTE APPROVAL
U(SPECTION RECORD
11
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ E ROUGH PLUMBING
TOTAL FEE OAS PIP]NO
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION OAS VeHT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR OAS TEST
AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL 0 OF TN BOVE UT LI CO R
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE FINAL
OP PERMITT
ROBERTA WOOD
Or VALIDATION SUPERVISING MECHANICAL ENG R
.
p
■ 0 WB
L&4 3 8 2 S% APR ] 5A 3.0 0
..r