HomeMy Public PortalAbout5849 TEMPLE CITY BLVD_Plumbing (2) &5&178A887.CEil817 4-64 `
APPLICATION FOR PLUMBI G -PERMIT
COUNTY OF LOS ANGELES_
DEPARTMENT OF COUNTY ENGINEER
BUII.DII�TG AND SAFETY .DMSION anILDISS
N ,$ L EG[T L.
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN, SUP'T OF BUILDING
LOCALITY E Aa yPZ
FOR APPLICANT TO FILL IN NEAREST T .
NUMBER FIXTURE OR ITEM EACH FEE CROSS
OWNER AG
WATER CLOSET $1.25 MAILd
BATH TUB 1.25
ADDRESS SA M C--.
CITY TEL. NO.
SHOWER 1.25
LAVATORY 1,25 CONTRACTOR P E- 50,0',f FZ&AAAAAri
7
SINE 1.25 ADDRESS 18 V
DISHWASHER 1.25 CITY O ^L TEL.NO.K$2-$/ `J 7
SATE gr
LAUNDRY TUB 1.25 REGISSTTRAATION NO. 1 72 0G 7 COTUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO GROUP ZONE P CES r BY
WATER HEATER 1.50 0 � _ C... zi 7
GAS SYSTEM OUTLETS 1.50 INDUSTRLAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .80 INSPECTION RECORD U
HAM e#o l3 sl p
f..
U
W
- a
h
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE D GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PPLICATION GAS VENT
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
i HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN.THE ABOVE DESCRIBED RESIDENTIA6APOPERTY. UTILIT_Y CO.NOTIFIED
SIGNATURE.
�-
OF PERMITTEE 10
FINAL
VALIDATION ROBERT A.WOOD
CK' M..0. CASH SUPERVISING MECHANICAL ENG'R
LAC6 6 2 9 2E DEC 9 5 D 6.0'0— 9