HomeMy Public PortalAbout5825TEMPLE CITY BLVD_Plumbing (2) D,.S.47 25M SETS 18-4b ' APPLICATION FOR PERMIT
+,,DEPARTMEUNT OF OS AING NGELESAND SAFETY
scx'• WM.J. FOX.CHIEF ENGINEER MB1 NG
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES H
COMPL6I'6G � aq'/HEATER CESSPOOLSEPTIC TANK RBCEIVBD BY READY FOR DATE ISSUED
FIRST INSPECTION ,I �/�'
SAB MISCELLANEOUS 1 �+ .Ay-w�'' INS �/r / /0
APPLICANT FAL IN HEAVILY OUTLINED PORTI 01%Y
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ADDRESS
ADDRESS LOCALITY'
j j��I9� "�✓'
NEAREST'
p, CITYTEL.No. CROSS ST.
COUNTY' '
CERT.No. EXPIRESI NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL
NORTH. 0 ADDRESS
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cITY TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOV .`'LOS
ANGELES COUNTY CERTIF OF qU LATIO
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I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
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CORRECTIONS
SOUTH 4
DESCRIPTION OF WORK
—BATH TUB FURNACE -
SHOWER. DISHWASHER
—LAVATORY REFRIGERATOR
—KITCHEN SINK WATER SOFTENER
FLOOR SINK RAND TRAP
P SINK -FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUt4TAIBF
DATE INSPBcroR's NAYS
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
METER----GAS SODA FOUNTAIN
OUTL GAS PIPING
SAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTUREB SEPTIC TANK. I U
E8SPOOL_. SEPTIC TANK (J SEWER
fi UTILITY CO.NOTIFIED
TOTAL FEE / {/
1 FINAL