HomeMy Public PortalAbout5013 FIESTA AVE_Plumbing__ 76A667 CE4817 4 67 CITY OF TEMPLE CITY
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r APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE I OWNEF /
WATER CLOSET $1 25 MAIL
BATH TUB 1251 ADDRESS
SHOWER 1 25 LCITY TEL NO
LAVATORY 4.2,,,. CONTRACTOR
SINK 1 25 ADDRESS
DISHWASHER 125 CITY TEL NO
STATE LIC
LAUNDRY TUB 125 LICENSE NO CLASS
CLOTHES WASHER 1 25 DISTRICT NO GROUPZONE PROC SSED BY
WATER HEATER 1 50 �,O U xR' I
GAS SYSTEM--OUTLETS 1 50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD a
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK A
0ROUGH PLUMBING `4-
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TOTAL FEE CAS PIPING �
I HEREB" ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION G45 VENT
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LFGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL Gf €C Z-�--
,,-�LIDATION JACK R ALLEN
CK,/ M O CASH SUPERVISING MECHANICAL ENG R
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76A667 CE#817 2 66 CITY OF < ' TEMPLE CITY B26175
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING -
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUPT OF BUILDING
LOCALITY
Temple C i t
FOR APPLICANT TO FILL IN NEAREST
CROSS Sr Lower Azusa & Temple Cit
NUMBER FIXTURE OR ITEM EACH FEE
OWNER Roy Workman
WATER CLOSET $1 25 MAIL
BATH TUB 125 ADDRESS same
SHOWER 1 25 CITY Same TEL NO
LAVATORY 125 CONTRACTOR General Installation Co.
SINK 125 ADDRESS 6558 west Blvd.
DISHWASHER 125 CITY Los Angeles TEL NO PL 3-2541
STATE LAUNDRY TUB 1 25 LICENSE NO I C-36 151839_ CLASS
CLOTHES WASHER 1 25 1 'DISTRICT NO GRO ZONE P S BY
WATER HEATER 150 1
GAS SYSTEM OUTLETS 1 50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD v
WATER SOFTENER Ready for Inspection Now
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 3150GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO GAS TEST
RESIDE IN THE ABOVE DESCRIBED RESID TIAALLL PROPERTY( UTILITY CO NOTIFIED
SIGNATURE G /c
OF PERMITTEE FINAL !07 ��
VALIDATION JACK R ALLEN
cK M O CASH SUPERVISING MECHANICAL ENG R
r •- I Air 9 1 4 1 w, APR 3 5 D 3 50-
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