HomeMy Public PortalAbout5910 TEMPLE CITY BLVD_Plumbing a
76AG67 (CE-817)- 5/73c2 6,
APPLICATIO OR PLU BIN,G PERMIT •
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION _
MAKE CHECKS PAYABLE TO: FBUILDING
jHARVEY T. BRANDT, COUNTY ENGINEERTYFOR APPLICANT TO FILL IN (PRINT OR TYPE) TST.
NUMBER FIXTURE OR ITEM @- FEE
WATER CLOSET 1,75 OWNER �J
MAIL <
BATH TUB 1.75 ADDRESS Q
SHOWER 1.75 CITY +(� TEL. NO.
LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS 5 d AAA
DISHWASHER' 1.75 CITY� � �/ TEL. NO..
CLOTHES WASHER 1.75 STATELIC J
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. ZOOZ Q CLASS
DIS T_Fjje�O� C'RO�I P ZONE CESSE BY
LAWN SPRINKLER SYSTEM 1.75 �`QQJJ�_ CC((�+//(( /j�Z �r/!.ty�/�s
J' WATER HEATER 1.75 WASTE APPROVAL y:
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD CD
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OUTLETS OVER v
5 PER SYSTEM .30 C�
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING - -2 - 62
Address < GAS PIPINGf
GAS VENT _
City L — Tel. No.z" G
HOT WATER HEATER �2-1� ��
I HEREBY ACKNOWLEDGE THA I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES' Z• �
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST ✓ r Sr , p a
I HEREBY CERTIFY THAT ROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED r
LICENSED AS RECUIRED'B L GELES COUNTY AND STATE OF
CALIFORNIA OR THmm��
TO
RESIDE IN THE ABOVp q
.. FINAL
SI GNATLI RE
OF PERM ITT E
PERMIT VALIDATION CK. )0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
9 6 2NFEB �6 5 u 1 8.7 5 �",b
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