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HomeMy Public PortalAbout5920TEMPLE CITY BLVD_Plumbing 78A8e7 13195-17 12.04 APPLICATION FOR PLUMBING PERMIT DIVISION OF BURDING AND SAFETY Deportment of County Engineer County of LOB Angeles BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY WMAPPLICANT.TQ FILL M EAST CROSS ST. OWNERDISTRICT NO. IF GROUP I ZONE READY FOR INSPECTION MAIL ADDRESS � oC INDUSTRIAL CITY TEL.NO WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY T ` LICENSE NO. NUMBER •TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO. ® 0.80 (�® APPROVALS rL01� DATE INSPEBTOR'S SIGNATURE GAS SYSTEM=/—OUTLETS Q 1.00 3 1 , WATER HEATER ® 1.00 UNDEftAh-pfWORK ROUGH PLUMBING t3 PO PERMIT S I 1 00 GAS PIPING TOTAL FEE pv GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST 31' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO. NOTIFIED CALIFORNIA OR THAT I AM THE LEGAL WNER OF ABOVE DESCRIBED RESIDENTIAL PROPERTY. 1 SIGNATURE FPERMITTE FINAL 'S"� �' !!<'r�.r/ WILLIAM J.FOX,COUNTY ENGINEER VALIDATION 15 '6 5S NAR 14 3 2.60 � BY � , DEPUTY