HomeMy Public PortalAbout5014AGNES AVE_Plumbing (4) 7GA88' CE#817 12 64 City of Temple City B 9276
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND E SAFETY ENGINTY EER ER ADDRESS 5014 No. Acines
COLEMAN IN JENKINS SUP T OF BUILDING LOCALITY Tem le Cit
FOR APPLICANT TO FILL IN CRo35 ST La Rosa & Baldwin
NUMBER FIXTURE OR ITEM EACH FEE
CROSS
Jim Thompson
WATER CLOSET $125 MAIL
BATH TUB 1 25 ADDRESS Same
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR General Installation Co.
SINK 125 ADDRESS 6558 West Blvd.
DISHWASHER 125 CITY Los Angeles TEL NO PL 3-2541
CTOR S STATE [X
LAUNDRY fUB 125 REGISTRATIONNNO C-36 151839 7sTAT
87COUNTY
E Ex
CLOTHES WASHER 1 25 DISTRICT NO GROUP ZONE PROC-SSXb BY
WATER HEATER 150
GAS SYSTEM OUTLETS 1 50 INDUSTRIAL
WASTE APPROVAL
___4OUTLETS OVER 5 PER SYSTEM 30 INSPECTION= CRECORD V
` Ready for Inspec` tion Nox,
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSEDAS 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 RESIDE AL eROPE r UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
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/-�LIDATION ROBERT A�"WOOD
cK M O CASH SUPERVISING MECHANICAL ENG R
5 6 1, 0�g Nov 2 5 0 350- 111-1