HomeMy Public PortalAbout9568, 9570 BROADWAY_Plumbing__ APPLICATION FOR PLUMBING ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ( C p Broadway
'JOHN A. LAM BI E. COUNTY ENGINEER 7l7 Y
WILLIAM A. JENSEN, SUPT OF BUILEMNG
Temple City
, ..,. `. ° FOR APPLICANT TO FILL IN *%^NUMBER FIXTURE OR ITEMJack HerveyWATER CLOSET �'HATH TUB lu
1121 Hi hland Vaks
cadia TRL.No. HI-627bb
• SHOWER
CONTRACTOR .Parker Plumbing'
LAVATORY f
SINE xj ADDRESS 14617 E. Ramona Blvd.
DISHWASHER C111Baldvin Park TEL- NO. ED-81127
CONTRACTOR'S 1' STA
LA=TUB BEGL;7R11T10N NO. ]_ �} COUNTY
CLDISTRICT NO. GROUP ZONE P SSED BY
C:WA+i '1`' GAINDUSTRIAL V
� WASTE APPROVAL
/ INSPECTION RECORD
W
YI tx U
i' o $1.00 PER ITEM /t
DR FIXTURE $ / APPROVALS DATE, INSPECTOR8 SIGNATURE
PERMIT $ P 00 UNDER SLAB WORK :,/;////3
//�� �
TOTAL FEE A ROUGH PLUMBING V7/ 0'
GAS PIPING
4:1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ANO.`BTATE THAT THE gBOVE 19 CORRECT AND AGREE TO COMPLY- GAS VENT
WITH' ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
t' eiu NieiNc: : HOT WATER HEATER
"I..HEREBY'�CERTIFY THAT i AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
L I CENSED'A. REQUIRED BY LOS ANGELES COUNTY AND •TATE OF
CALIFORNIA� OR THAT 1 AM THE LEGAL OWNER Or.
ABOVE GAS TEST
d DESCRIBED RESIDENTIAL ROPER UTILITY CO. NOTIFIED
- I BIGNATURE // l �'
x OF,PERMI E L"L'L -
- FINAL ,%% �m '
• VALIDATION ROBERT A. WOOD
df i
CK. M.o. CASH SUPERVISING MECHANICAL ENG'R
x ,
r,.P
,. 1