HomeMy Public PortalAbout9626 1/2 BROADWAY_Plumbing__ .BS-17I."
3APPLICATION FOR :PLUMBING .PERMIT
DI 7
1
• DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING
WM.J. FOX. COUNTY ENGINEER ADDRESS 9626 T3TOadji,Ia
CASSATT D. GRIFFIN, SUPT OF BUILOING
LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER Pet eTS OCL DISTRI GROUP I ZONE I PEPOY FOq INSPECTION
MAIL - S ��/
_ADDRESS
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER Ear(h T,(PI � S1:anrl�o11vttTm'n _ INSPECTION RECORD
ADDRESS ��Q14� �O� P.n _4nl'1 Il � "i I51 5�•.`�
CITY El 1.1OIZtiP(]
LICENSE NO. 149236 r5" .0/\ )1 4')A1
NUM6ER TYPE OF FIXTURE OR ITEM FEEL- 1 ` y 1 I
WATER CLOSET (TOILET) 5 1 .foVt�o `C� N �(�. �Y�P+.�,
1 BATHTUB 1
SHOWER !1/� �V+Y�J� 1 9•
LAVATORY (WASH BASIN) �/I/
1 KITCHEN SINK 1s0c
DISHWASHER
LAUNDRY TUB OR TRAY
1 CLOTHES WASHER 1�OQ
TOTAL NO. 0 0.80 APPROVALS
-m� DATE INSPECTOR'S SIGNATURE
GAS SYSTEM`' OUTLETS @ . 1.00
UNDER SLAB WORK
WATER HEATER � @ 1.00 n
ROUGH PLUMBING II . _
PERMIT 5 1 00
- GAS PIPING
TOTAL FEE 00 GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER ILII
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES '
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST - 'S
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL MINER OF THE ABOVE UTILITY CO. NOTIFIED STI.
DESCRIBED RESIDE PR PERT "/�J�/ `� �✓
SIGNATURE I C l�'_J+l•1-
OFPERMITT E FINAL
.
WILLIAM J. FOX. COUNTY ENGINEER VALIDATION R. A.WOOD, CHIEF FLBG, INSPECTOR
Ao�i9,0 5� OCT 30 3 $.00 M