HomeMy Public PortalAbout5821TEMPLE CITY BLVD_Plumbing (2) ,BB
APPLICATIONFOR OR PLUMBING PERMIT
lB.17 O-B$
IM !N OF BUILDING AND SAFETY
Deportment of County Engineer {
County of.LOS Angeles BUILDING
DDREIN V JOHN A.LAMBIE, COUNTY ENGINEER
CASSATT D..GRIFFIN,SUPT OF BUILDING
LOCALITY 2111- cd.
FOR APPLICANT TO FILL IN I CEASES T. i�P�
OWNER i7� 0 (/... a DISTRICT NO. GROUPZONE READY FOR INSPECTION
MAIL �7 I�..� I
ADDRESS oC
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS 78 L dr — 6 �- t dQ l
CITY e/YL /Q. Ci/ .TEL.NO. r22
LICENSE NO. L{/ 3 6!�
NUMBER 11- TYPE OF FIXTURE OR ITEM FEE
/i WATER CLOSET (TOILET) A $1.00 b
BATHTUB @ $1.00 k3 _ tk
SHOWER 'Y @ $1.00
LAVATORY (WAS11 BASIN) @
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
APPROVALS
DATE INSP CTOR 'SIGNATURE
UNDER SLAB WORK ct S 'JCb A /1
PERMIT $ 1 00 ROUGH PLUMBING 10 's S,��i va�AAI.w —
GAS PIPING
TOTAL FEE lop
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 /�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES al t SC,. tri"
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ' GAS TEST tt 61
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ((
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOT.IRIEDIf
DESCRIBED RESIDENTIAL PROP TY.
SIGNATURE
OF PERMITTE FINAL 14 1 d►
r
IOHN A.LAMBIE.COUNT ENGINEER VALIDATION ROBERT A.WOOD,CHIEF PLBG...INSPECTOR
CK, M.0. CASH
L&9 8 4 1m Se 4" 3 14-00
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