HomeMy Public PortalAbout9166 LA ROSA DR_Plumbing__ 76A867-CE*817 4-64 CITY OF T&PLE CITI
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION anDREss 9166 La Rosa Dr.
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
Temple Citi
FOR APPLICANT TO FILL IN CROSS sr. Enc finita
NUMBER FIXTURE'OR ITEM EACH FEE OWNER Ceummity Disposal
WATER CLOSET $1.25
BATH TUB 125 ADDRESS 9167 La Rosa Dr.
SHOWER 1.25 CITY Temple City TEL. NO. AT 63422
3 LAVATORY 1.25 CONTRACTOR Aere Plumb Co,
1 SINK 1.25 ADDRESS2845 N.Darfee. Ave,
DISHWASHER 1.25 CITY El Monte - TEL. NO. GI 246M '
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. 229768 COUNTY
CLOTHES WASHER 1.25 DISTRI T NO. GROUP I ZONE PR ESSED BY
1 WATER HEATER 1.50' 1 0
], 1.50 INDUSTRIAL o
GAS SYSTEM �I OUTLETS J� "�3�i�'-� .1-� 'Z•
WASTE APPROVAL Zp s
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
1 Drinking Ftn 1.25 c _� p
6 Flr Drns ,� '- I
6- Para fluid receptors 7i 0
r ,
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_2 'd-11 APPROVALS DATE, INSPECTOR'S SIGNATE
UR
PERMIT $ P 00 UNDER SLAB WORK �0` f�(� +�/r n'�+•�l
ROUGH PLUMBING
TOTAL FEE 30,900GAS 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 HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT 1 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 O R OF,AND INTEND TO
RESIDE IN,THE ABOVE CRIBED ESIDE I L PR UTILITY CO NOTIFIED
SIGNATURE i I
OF PERMITTEE / l
FINAL 1. t'jjT1
ALIDATION ROBERT A, WOOD
CK. M O. CASH SUPERVISING MECHANICAL ENG'R '
{;o 7 8 0 9 JAN 2 5 D 30.00,
r.