HomeMy Public PortalAbout5919 TEMPLE CITY BLVD_Plumbing (2) O.B. 17'SSM SETS 18-43 APPLICATION FOR PERL1Eli
DEPARTMENT.OF BUILDING AND- SAFETY•:. . :, - , -
COUNTY 'OF LOS ANGELES PLUMBING
WM.J. FOX.CHIRP ENGINEER
NATURE OF INSTALLATION DISTRICT O. GROUP —ZONE PERMIT O.
ROUGH . -ml xrUREs -�
I-EOMPLRTE
HEATER CESSPOOL 11� I BEPTICTANK LCRIVRD HY READY.FOR DATE 188UEDPIRBT N��aj ? - 1741AS MIBCELLANROU LC+ (
IS
APPLICANT
PPPLICCANTFILL IN HEAVILY OUTLINE/D PORTION ONLY
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C NAME / "qJ,(i/_ /��syyG///L/GZ/�PiL/. ae -. ADDRESS
m ADDRESS. ,./n L+�f�'1��/!J/V!/�7 � �/i LOCALITY..
ST
d c17Y, l PsM.r.l �` (' `rRl..No. CROGS ST.
COUNTY
CERT.No. `' EXPIRES
M NAME i t✓
LOCATYON OF SEPTIC.TANK, OR CESSPOOL tdMAIL
NORTH O A
ADDRESS �.i 1_A
_
CITY s?�C�G' TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF
QUALI
FICATIO
N:)
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
3 W OWNER
i CORRECTIONS
SOUTH J
DESCRIPTION OF WORK - z
BATH TUB FURNACE 0
tY
SHOWER DISHWASHER O
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR BINK SAND TRAP
SLOP SINK -FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING i
METES GAS SODA FOUNTAIN GAB PIPING
OUTL
GAS VENT
OOL I it '� I
TOTAL NUMBER OF FIXTURES TANK
E68P00tSEPTIC TANK �1
S UTILITY CO.NOTIFIED I
TOTAL FEE ,
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