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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING
NUMBER FIXTURE OR ITEM FEE ADDRESS 5723 N. Reno
WATER CLOSET LOCALITY Temple City
NEAREST ,
BATHTUB CROSS ST.
SHOWER OWNER Norma Wheeler
LAVATORY MAIL. 5723 N. Reno
ADDRESS
SINK CITY Temple City TEL.N0287-0019
DISHWASHER CONTRACTOR Bryant Heat. & Air Cond
CLOTHES WASHER ADDRESS 1350 E.., Las Tunas
SWIMMING POOL RECEPTOR
CITY San Gabriel TEL.NO. 28.6-114
LAWN SPRINKLER SYSTEM
WATER HEATER
LICENSE NO. 2 217 51 CLQ C 2 0
1 GAS SYSTEM OUTLETS 3 .00 APPROVALS DATE INSPECTOR'S SIGNATURE
'OUTLETS OVER UNDER SLAB WORK'
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING. t
GAS VENT V
HOT WATER HEATER 0
PLUMBING FIXTURES
GAS TEST !� N
Plan check fee UTILITY CO.NUTIFIED Z
PLUMBING PERMIT ISSUING FEE$ 700
TOTAL FEE 1 O O O FINAL —
Plan check applicant PLAN CHECK VALIDATION
Name .J�+ 2�• '.�'�'✓J
Address Al- "
City Tel.No.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE •'
THATTHEABOVE IS CORRECT AND.AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ;2 4'2.1•7 A
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
i HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS # 011 O O O 5
REQUIRED BY LOSANG COUNTY AND STATE OF CALIFORNIA OR THAT'I AM THE
LEGAL OWNEROF,AN IN ND TO RESIDE IN THE ABOVE DIESCR18ED RESIDENTIAL. • 2 O O ' Q 0 0
PROPERTY.
SIGNATUREJJ A n /�[ _ O O O 1 Q004,
OF PERM-r •/�-3 If '
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DISTRICT NO. CESVd BY 06,07-79
INDUSTRIAL "
WASTE APPROVAL