HomeMy Public PortalAbout6040 CLOVERLY AVE_Plumbing__ r
CITY OF TEMPLE CITY
7GA667 CE#817 5 51
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APPLICATION FOR PLUMBING PERMIT -
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING A E SAFETY DMSON BUILDING 6 0 40 N . C l o v e r l yJOHNACOUNTY ENGINEER
WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY Temple City
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FOR APPLICANT TO FILL IN NEST Woo r U -F-Ave .
CROSS ST
NUMBER FIXTURE OR ITEM OWNER Miller--Attract 1 v e Homes
WATER CLOSET f,�`j MAIL
ADDRESS
HATH TUB J
CTTY TEL. NO
SHOWER
LAVATORY
CONTRACTOR Earl Pat S t a d e
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sam /,�
ADDRESS P. O. Box 408
DISHWASHER crrY El Monte TEL NO CU 36303
LAUNDRY TDB REGISTRATIONSNO 149236 v Com
CLOTHES WASHER DISTRICT NO GRQMP ZONE P CSSSEI BY
WATER HEATER ��� I ( Z o
GAS SYSTEM ,S� INDUSTRIAL 0
WASTE APPROVAL v
INSrPECTIrON/RECORD 0
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✓A..�� E,( �.<?tel *'�.Ip,�-jl l7' ,/1�- '--4- Vf
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e $100 PER ITEM
OR FIXTURE $ C/� APPROVALS DATE INSPECTOR B SIGNATURE
` PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING �/� /{ '/'7 / /
TOTAL FEE I 1071 q�,��
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING '
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES _
LICENSED AS REQUIRED BY NGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE EGAL H OF T ABOVE GAS TEST
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED /
SIGNATURE
OF PERMITTE FINAL
VALIDATION ROBERT A WOOD IV
(SCK M O CASH SUPERVISING MECHANICAL ENG R
I 5 6 4 0 1"R 27 5 0 1 125'
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