HomeMy Public PortalAbout9236 FLAHERTY ST_Plumbing__ 76 A 667 — CE+817 7-69 CITY OF TEMPLE CITY , y
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES B46401
DEPARTMENT OF COUNTY ENGINEER 2'
BUILDING AND SAFETY,DIVISION BUILDING ADDRESS 9236 aherty a
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY Temple Clt `
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST e
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NUMBER FIXTURE OR ITEM EACH FEE
OWNER H. F. "ShU3t s
WATER CLOSET t 1 50
MAIL
BATH TUB 1 50
ADDRESS Same
SHOWER 'i' 1 s0 CITLY rY TEL NO 287-0025,
a (LAVATORY 1 50 CONTRACTOR General InstaHation�C,o
S) 1 so ADDRESS Los
A� 6558 West Blvd-
-4 DISHWASHER � ' 1 50 CITY Los Angeles TEL NO ~PL 3-2541 �
CLOTHES WASHER 1 50 STATE I LIC
r LICENSE NO C-36 151839 CLASS
SWIMMING POOL RECEPTOR., 1 s0
D1ICTDNOy GROUP Z014E P� ES BY '
LAWN SPRINKLER SYSTEMn 2 00
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1 WATER HEATER Y + 1 50 1 50 WASTE AP R >
OVAL 1 Or
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GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD
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OUTLETS OVER Z
5 PER SYSTEM L 30 Ready for Inspection Now
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Plan check fee 25% of above See reverse y _
PLUMBING PERMIT ISSUING FEE $ 1 2 00
TOTAL FEE + 3 0 APPROVALS DATE � INSPECTOR S SIGNATURE
Plan check applicant x UNDER SLAB WORK
Name , ROUGH PLUMBING
Address; ^ „ a GAS PIPING J
i GASVENTh
i
City Tel No HOT WATER HEATER � x
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES d
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
I»HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED r
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF {
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DE&CRIBED :FINT 11�PR RTY
//..}}�'//dd//// FINALSIGNATURE ; JACK R ALLEN SUPERVISI ECHANICAL ENG R
OF PERMITTEE
�, PERMIT VALIDATIO c M o CASH
PLAN CHECK VALIDATION CK M o t CASH n s +
Ail 4 ' �e {�.. t,3s 95 �i�2� VAN I ;' 5 DJ aO
76R'667 CE t$B 17 2 62 /
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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
WILLIAM A JENSEN SUP T OF BUILDING H
LOCALITY l!_'
FOR APPLICANT TO FILL IN NEAREST
ROSS ST /
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $125 MAIL
BATH TUB 125 ADDRESS
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINK I25 ADDRESS
DISHWASHER 125 CITY L
LAUNDRY PUB 1 25 CONTRACTOR S STATE ❑
REGISTRATION NO �/ COUNTY El
CLOTHES WASHER 1 25 DIS�ICT NO GROUP E POCE SE B
WATER HE 1 50 � �( R,
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GAS SYSTEM OUTLETS 150 INDUSTRIALWASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 t
INSPECTION RECORD
O
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u
aW
to
z
1
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT t $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE `3 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 I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND TEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDE I PROPE UTILITY CO NOTIFIED
SIGNATURE A ` f '1 /7/! Wf/
OF PERMITTE —
FINAL '
ALIDATION ROBERT A WOOD Y
CK M o CASH SUPERVISING MECHANICAL ENG R
I
LJLo 8,9 4 3D>1 CLEC 2 8 5 D 350 -
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