HomeMy Public PortalAbout5916 TEMPLE CITY BLVD_Plumbing (2) D.S.S.17 1111&1 sun 1.48 APPLICATION FOR PERMIT
DEPARTMENT OF BUMIDING AND SAFETY t '
CWM.J. FOX.CHIEF ENGINEER OUNTY OF LOS ANGELES PLUMBING
NATURE OF INSTALLATION 01wrRICT No. G Up rc /e P /1 o.
ROUGH FIXTURESCOMPLETE
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HEATER CESSPOOL HSEP`rIC TANK RECEIVED BY READY FOR . ` DATE ISSUED
.e �) FIRST INSPECTION
GAS '
MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
NAME I�`1 _ \!/��` /,1 • `y_7�.�i_ ADDJOB
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ADDRESS _ 7_ + `s i�y.]^�.t"+/. i 241 LOCALITY' r 1-Z l�'�
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CITY !�/I/,f �iZ�A � EL.No. CROSS ST.
COUNTY'
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CERT.No. McPIRES C NAME � f!`3'�
LOCATION OF SEPTIC TAAK, OR CESSPOOL, ZMAIL
NORTH
ADDRESS
CITY 'm TEL.No
1 AMTHELEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATIION/.� p
`PLumelft
I AM THE LEGAL OWNER'OR'TN6 PROPBRTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK z
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BATH TUB FURNACE
SHOWER DISHWASHER O
.LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
QLOOR SINKSAND TRAP
LOP SINK - QLOOR DRAIN
WASH TRAY - URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN
DATE IN9PEGTOR'®NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING /
METER------GAS. SODA FOUNTAIN / I
OUTL GAS PIPING
GAS VENTI_
CESSPOOL 1 � //
TOTAL NUMBER OF FIXTURES SEPTIC TANK SO
�CESSPOO� SEPTIC TANK r' SEWER I
S f UTILITY CO.NOTIFIED
TOTAL FEE
FINAL