HomeMy Public PortalAbout10520 LYNROSE ST_Plumbing__ 76A887-CE#817 S-51' .`OtTEMPLE C1�
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY E02MM
BUILDING AND SAFETY DMSION BUILDING''
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS 10520 Lynrose
WILLIAM A. JENSEN, SUP'T OF BUILDING LOCALTTY Temple Cit
FOR APPLICANT TO F1l.I. IN NEST, Pal Mal
NUMBER FIXTURE OR.ITEM 01ANlOi
Meeker- Land Rev.
2 WATER CLOSET
DAD S
F2 RATE TOR
CITY TEL NO.
1, SHOWER
CONTRACTOR Owen Bros. Plumbin
2 LAVATORY
1 Sn� AaaREss 525 No Baldwin Avee
DISHWASHER CTrY El Monte T=NO. GI-37644
NTRAGT 's STATE
LAUNDRY TOR RREOc� ON NO. 197184 COUNTY' .
1. CLOTHES WASHER DISTRICT NGROUP ZQNE SSED BY
1 WATER'HEATEB V -1.
lINDUST uAL
GAS SYSTEM WASTE APPROVAL IN
WSPECnON'RECORD„ . 0
W
N
Z
$1.00 PER ITEM nn
10 .ORFnCTURE $ I 1 eOV APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 5 2100 UNDER SLAB WORK
TOTAL FEE a ROUGH PLUMBING WL
GAS PIPING 0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT _ n del/
WITH ALL G°OUNTY ORDINANCES AND STATE LAWS RMULATINd �✓'�/�✓��
PLUMBING. HOT WATER HEATER r'
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/Olt PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS,ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO.NOTIFIED
SIGNATURE A I /All
OF PURM17TEE FINAL /yy
1h—)Aa— �R%C++L���
AMATION ROBERT W WOOD v r
CK M.D. CASH 'SUPERVISING MECHANICAL ENG'R
to
u10 1 4 7 4 APR 2 0 5 A 1 5.0 0
7GA887C )C6-81713) -9 75
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APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING .D
NUMBER FIXTURE OR ITEM @ FEE ADDRESS —//(//C
WATER CLOSET
LOCALITY CC
NEARESTJ—
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY ..+ TEL.NO.
DISHWASHER CONTR C i `� e
CLOTHES WASHER • E. .,i tf �� � a
ADDRE �2pp��
SWIMMING POOL RECEPTOR CITY TEMPLE I 9 �{ 707 0
LAWN SPRINKLER SYSTEM aL / �J
STATELIC
WATER HEATER a LICENSE NO. 'w (�-/ey CLASS o
GAS SYSTEM OUTLETS DISTRACT N.O. I GROUP IZPE RO SED BY ~OUTLETS OVER O
5 PER SYSTEM INDUSTRIAL LSI
WASTE APPROVAL y
INSPECTION RECORD Z
Plan check fee 3
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE '
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. NO. GAS PIPING.
I HEREBY ACKNOWLEDGE THAT I 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 HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNEDOF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIB R DENT A PROPERTY. UTILITY CO. NOTIFIED
SIGNATU RE
OF PERMITTEE FINAL 7
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
R U.'� FOS' d'�,> A� ���S E TIO �1 7� 0 'w