HomeMy Public PortalAbout4834 CAMELLIA AVE_Plumbing__ 6A66�C t � ' 0-d
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APPLICATION FOR .PLUMBING PERMIT .
BUILDING AND SAFETY DIVISION
FORAPPLICANT TO FILL IN(PRINTOR TYPE( ABUILDING
DDRESS 4834 TS,TQ AVE.
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY TkAPLE
CITY
NEAREST
BATHTUB CROSS ST.
SHOWER OWNER W11SON M IAEL
LAVATORY MAIL
ADDRESS SANE
SINK CITY TEMPLE CITY TEL.No.285-5990 ,
DISHWASHER CONTRACTOR TRANE HCC
CLOTHES WASHER ADDRESS 2034,N. PECK RD.
SWIMMING POOL RECEPTOR
CITY S. EL P= TEL.No.579-7982
LAWN SPRINKLER SYSTEM STATE
WATER HEATER LICENSE NO. 265094 CLASS C-20
1 GAS SYSTEM 1 OUTLETS 3 DI
00 STRICT NO GROUP ZON; PR SSED BY
OPER TS OVER O
INDUSTRIAL G
WASTE APPROVAL O
INSPECTION RECORD V
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O
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W
6
VI
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Plan check fee
PLUMBING PERMIT ISSUING FEE$ 4150
TOTAL FEE 1 7150
Plan check applicant '
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING 117 ±i7t9aAv
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT v ,
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALLCOUNTY ORDINANCES - - -
ANDSTATELAWSREGULATINGPLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT'I AM THE GAN TEST
LEGAL OWNER OF.AND INTEND TO RESIDE IN i BOVE DESCRIBED RESIDENTIAL
PROPERTY. 1414dUTILITY CO.NOTIFIED
SIGNATURE iii
.OF PERMITTEE - - NAL
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PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONcK. M.o. CASH
9 3<1.-JUN .9 5 D 7.5 0 ®S"