HomeMy Public PortalAbout5821TEMPLE CITY BLVD_Plumbing FGA887 APPLICATION FOR PLUMBING PERMIT 1
795.17 IO-ss
ffil i OF BUILDING AND SAFETY
Deportment of County Engineer
County of LOB Angeles BUILDING
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN I NEAREST
CROSS ST.
OWNER DISTR CT NO. GROUP ZONE READY FOR INSPECTION
MAIL (r
ADDRESS o
INDUSTRIAL
CITY TEL.NO. WASTEAPPROVAL!4j!!ja V
PLUMBER SP CTION RECORD "
ADDRESS
w
CITY
LICENSE NO.
NUMBER TYPE OF FIXTUREfOR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
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
GAS SYSTEM @ $1.00
D`
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ I 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE
GAS VENT
1 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 REdUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL P:OP Y.
SIGNATURE
OF PERMITTE FINAL
IOHN A.LAMBIE,COUNT ENGINEER VALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
CK. N.0. CASH
LIM00 5- 0 1 LA SEP 24 3 2.00 '�