HomeMy Public PortalAbout5817TEMPLE CITY BLVD_Plumbing '
RR-17,o-ss APPLICATION FOR PLUMBING PERMIT 1
Is.n
DIVISION OF BUILDING .AND-SAFETY
Dep caIQlent of County Engineer
County of Los Angeles BUILDING o' �,
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS @Nl�CT ! tO }-
CASSATT D.GRIFFIN.SUPT OF BUILDING �� f
LOCALITY
FOR APPLICANT TO FILL IN• NEAREST
I CROSS ST. 1 /9-
OWNER DIST ICT NO. GR 6�J�O�'ZONE L READY FOR INSPECTION
MAIL
ADDRESS
•INDUSTRIAL
CITY' TEL.NO." WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CI Cf- A If TEL.N
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @.$1.00 5 - 1100
BATH TUB @ $1.00
SHOWER @ $1.00
'JLAVATORY (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
GAS SYSTEM @ $1.00 O
APPROVALS
DATE I P CTOR'S GNATURE,
UNDER-SLAB WORK '� -d
PERMIT $ 1 00 ROUGH PLUMBING aft . $ .
GAS.PIPING
TOTAL FEE s J 001 1 GAS VENT
I HEREBY ACKNOWLEDGE THAT I 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. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR T T I AM THE LEG L OWNER OF THE RBOVE UTILITY CO.NOTIFIED
DESCRIBED RESI NL PROP.
SIGNATURE
OF PERM ITTE 'r FINAL
OHN A.LAM COUNTY ENGIN VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CK. M.1. CASH
�,��8 9 3 0 AUG -6 3 5.0 0 In