HomeMy Public PortalAbout9629 BLACKLEY ST_Plumbing__ 76A667 (CE-817) - 5/73 B 23711
APPLICATION FOR PLUMBI• G Pi;�.IT
COUNTY OF LOS ANGELES CITY ,OF TEMPLE CITY
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY.DIVISION
MAKE CHECKS PAYABLE TO: ADDRESNs 962-9 •C'Blackle
HARVEY T. BRANDT, COUNTY ENGINEER LOCAL•ITV - Temple City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST,.
NUMBER FIXTURE OR ITEM @. FEE
;I OWNER H. Sherrard
WATER CLOSET 1.75
MAIL
BATH TUB 1.75 ADDRESS` Same
SHOWER 1.75 CITY TEL. NO. 286-9686
LAVATORY 1.75 CONTRACTOR GENERAL INSTALLATION CO.
SINK 1.75 ADDRESS 6558 WEST BLVD.
DISHWASHER 1.75 CITY Los Angeles TEL. NO. PL 3-2541
CLOTHES WASHER 1.75 STATE LIC
LICENSE-NO: C 36451839 CLASS
I SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP ZONE /�OCESSE 'BY
LAWN SPRINKLER SYSTEM 1.75 p
WATER HEATER 1.75 1 .75 INDUSTRIAL V �J
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
U
OUTLETS OVER
5 PER SYSTEM .30 Ready for Inspection NOW 0
F--
WATER SOFTENER i w
Pian check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
' TOTAL FEE 4•7S
APPROVALS DATE INSPECTOR 5 SIGNAT4RE
Plan check applicant- UNDER SLAB WORK
Name ROUGH PLUMBING Yr Or
Address GAS PIPING d b
City GAS VENT / r1 •�V
I HHOT WATER.HEATER
!
_ Tel. No. ry
��rYA AV
EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION �
AND STATE THAT THE ABOVE IS CORRECT AND AGREE JO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST f
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF tz
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDE OPE Y.
FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK. M,O. CASH
PLAN CHECK VALIDATION CK— M.0. CASH 0 1 9 SEF :20 5 •0 4.7 5 ,&-%