HomeMy Public PortalAbout5733-5735TEMPLE CITY BLVD_Plumbing (2) B$ ';I 'o, B4. APPLICATION FbR PLUMBING PERMIT 1
=Mi OF BUILDING AND. SAFETY
Department of County Engineer
County of Los Angeles BUILDING
JOHN A.LA.MBIE, COUNTY ENGINEER ADDRESS / 1 Gt
CASSATT D.GRIFFIN,SUPT OF BUILDING
LOCALITY e
FOR APPLICANT TO FILL IN I NEAREST w f
CROSS ST, IV
OWNER -DISTRICT NO. GROUP ZONES READY FOR INSPECTION
MAIL 4 1 I
ADDRESS � 1
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER j� , R(Yv ( G INSPECTION RECORD
ADDRESS i Dr r
CITY TEL.NO#W
LICENSE NO. �`� �' 4-8
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
13 LAVATORY (WASH BASIN) @ .$1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CL.OTHES WASHER @ $1.00
WATER HEATER @ $1.00
3 GAS SYSTEM @ $1.00 �
APPROVALS
DATE INS CTO.R'S SIGNATURE
UNDER SLAB WORK
PERM_ IT 00 ROUGH PLUMBING S � .. ...�
®� GAS PIPING !
TOTAL FEE z I 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' '• A
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES �P 1
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF `
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIALP OPER J
SIGNATURE /
OF PERMITTEE FINAL
OHN A.LAMBIE. COUT ENGINEER /VALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
#� s. J M.o. cAsx
LTO 8 i 3 4- Mqv 14 3 2 1 .0 0 �►