HomeMy Public PortalAbout5624-5626TEMPLE CITY BLVD_Plumbing F'70AG167
a 5e APPLICATION FOR
F�LUMBING PERMIT
DIVISION OF BUILDING AND SAFM
Depe:tment of County Engineer
County of Los Angeles
WM J FOX, COUNTY ENGINEER BDDRESSU ILDINO
A
CASBATTD GRIFFIN BDFTOI BUILOIMo
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
BB BT
OWNER DISTRICNO GROUP I ZONE AuoY Pox INFFECTIOP
MAIL ,�,If 3
ADDRESS
IN DUBTRIAL
CITY TEL NO WA APPR VA
PLUMBER INSPECTION RECORD
ADDRESS
i
a
CITY TEL
NO
LICENSE NO U I SIp
R.l
NUMBER "PC OF FIXTUx[OR ITEM F[[ .
WATER CLOSET (TOILET) s Y
BATH TUB
SHOWER
LAVATORY (WASH BAS IN)
KITCHEN SINK
DISHWASHER GA4 INE Ie
LAUNDRY TUDOR TRAY O� O A r1t1R
CLOTHES WASHER
O o D
4a wcc:z�
DUL
Q 64" v6
.. _ 1
TOTAL NO a Jew _ APPROVALS
DATE INS CTOR SIGNATURE
GAS BYSTE OUTLETS 1 00
WATER HEATER0 100 O UNDER SLAB WORK I
PERROUGH PLUMBING
MIT • 1 00 y
? GASPIPING �
TOTAL FEE . D GAS VENT
1 NEREBY 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 I AN PROPERLY REGISTERED AND/OR GA6 TEST
LICENSED A5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL ROPERTY
SIGNATURE
OF PERMITTEE FINAL 1�
WILLIAM J FOX, COUNTY ENG) VALIDATION R A WOOD,CHIB7 PLBG INSPECTOR
Lp3656A DEC 26 3 5300 tB