HomeMy Public PortalAbout5938 ROSEMEAD BLVD_Plumbing__ 76AG67�. QB-617) - 1/79 TEMPLE CITY ---
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ,
MAKE CHECKS PAYABLE TO: BUILDING .
Temp/jR
ADDRESS 38 semead Blvd
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
Cit
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
WATER CLOSET
2.00 OWNER qALD
MAIL
BATH TUB 2.00 ADDRESS aboyp
SHOWER 2.00 CITY Temple CityTEL. Ncg85-9407
LAVATORY 2.00 CONTRACT
SINK 2.00 ADDRESS 2034 N. Peck Rd.
DISHWASHER 2.00 CITY TEL. NC'C579-798'2
CLOTHES WASHER 2.00 STATE LIC
LICENSE N CLASS C-20
SWIMMING POOL RECEPTOR 2.00 DISTRICT NO.GROUPNE OCES D B
LAWN SPRINKLER SYSTEM 2.00 Sr _
WATER HEATER 2.00 D1 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00O
INSPECTION RECORD
OUTLETS OVER ,30 Q')
5 PER SYSTEM
CD
C~7
W
d
rn
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ .THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT' I AM THELEGAL OWN R OF, AND IA TEND TO J.
RESIDE IN THE ABOVE DESCRIBED RESIDENTI L PROPERTY. FINAL
SIGNATURE -
OF PERMITTEE - -
PERMIT VALIDATION CK. M,O: CASH
PLAN-CHECK VALIDATION CK. M.O. CASH '
8 7 8 t'2. , 27 5 0 7.50 AS8