HomeMy Public PortalAbout5622TEMPLE CITY BLVD_Plumbing (2) ,76A6e]CEeI]857 APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING ANDISAFETY DIVISION 1BiDDRBSSO C
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY Tefl le Cit
EGAS
ICANT TO FILL IN NEARS T
.-FIXTURE OR ITEM
CLOSET MAIL OWNER i• J I8n
UB ADDRESS
5 22 reDlplo City Blvd.
ER CITY Temple Cit TEL NO
ORY CONTRACTOR 9 OI7 F0018
ADDRESS 8 Klinszorne St
ASHERS A CITYLl Monte TEL NO
RY TUB CONTRACTORS STATE Ll
REGISTRATION NO COUNTY
ES WASHER
DISTRICT NO ROUW liG READY FOR IMBPECTION'
HEATEB. J
STEM INDUSTRIAL
WASTE APPROVAL-
INSPECTION RECORD
I J
E +
APPROVALS
Q $100 PEA ITEM DATE INSPECTOR S SIGNATURE
OR FLTIURE B / UNDER SLAB WORK
PERMIT f 1 00 ROUGH PLUMBING
GAS PIPING +�
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES,COUNTY AND STATE OF p
CALIFORNIA OR THAT I AM THE LEGAL OWNEB_OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL' PROPERTY
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SIGNATURE FINAL
OF PER _
®' I ( � {�> VALIDATION ROBERT A WOOD
� SUPERVISING MEC HANICA_ ENG R
CM M O CASH
r toy3,23 - ,M30 5 A 2.00
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