HomeMy Public PortalAbout5738-5738 1/2-5740TEMPLE CITY BLVD_Plumbing 78A887 (CE-817)-4/72. -
APPLICATION FOR PLUMBING -PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY'ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER
LOCAL
FOR APPLICANT TO FILL IN (PRINT OR TYPE) e
C�,SS-6fi-
NUMBER FIXTURE OR ITEMFEE
WATER CLOSET 1,75 OWNER
MAIL
BATH TUB 1.75 ADDRESS
SHOWER 1.75 CITY TEL. NO.
LAVATORY 1.75 CONTRACTOR r
SINK 1.75 AD S s
DISHWASHER 1.75
CLOTHES WASHER 1.75 STATEa� LIC
LICENSE N.O..1dZ141
CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP ZONE SED BY
LAWN SPRINKLER SYSTEM 1.75 ae ��PRqFE
-
WATER HEATER 1.75 IPDUSTRIAL
W STE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD CD
OUTLETS OVER 30
5 PER SYSTEM
a
CD22
Plan check fee Sea Reverse
PLUMBING PERMIT ISSUING FEE $ 31 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel.. No. GAS.VENT
HOT WATER HEATER
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND, STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CAL.I FO.RN IA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO ,
RESIDE IN THE ABOVE DESCRIBED RESIDEN PROPER rL
FINAL
SIGNATU RE
OF PERMITT .r
PERMIT VALIDATI CK. M.O. CASH
PLAN CHECK VALIDATION CK.. M.O. CASH
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