HomeMy Public PortalAbout5811-5811 1/2-5813TEMPLE CITY BLVD_Plumbing (2) FDIVISIONAPPLICATION FORPLUMBING PERMIT OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A..L.AMBIE. COUNTY ENGINEER ADDRESS.
CASSATT D,GRIFFIN�SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER / DISTRICT GR UP ZONE READY FOR INSPECTION
MAIL.
ADDRESS 1 J /
r INDUSTRIAL
CITY TEL.NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY •�srr/ TEL.NO.
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 S.
BATH TUB @ $1.00.
SHOWER @ $1:00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @. $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER. @ $1.00
WATER HEATER @ $1.00
AS SYS T M c. @ .01.00
APPROVALS
DATE INSPEC'TOR'S SIGNATURE
UNDER SLAB WORK.
PERMIT $ 7 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE
�® GAS VENT
I HEREBY ACKNOWLEDGE: THAT I HAVE READ THIS APPLICATION' HOT WA9 ER HEATER
AND STATE THAT THE ABOVE IS CORRQCT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY Al..LTADOVE
CALIFORNIA OR THAT I AM THE LEGAL 0 NER OF UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL . OP !!..SIGNATURE [J
OF PERMITTEE SINAL l2
OHN.A.LAMBIE.COUNTY ENGINE E --VALIDATION ROBERT A.WOOD.CHIEF PLBG..INSPECTOR
CIC.
M.0. CASH
2.0 0
9 41 FSI
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