HomeMy Public PortalAbout4450 TEMPLE CITY BLVD_Plumbing__ P" n .EN BET[ IP - APPLICATION FOR PXRILIT
'DEPARTMENT OFNG AND SAF
COUNTY J. OX.F SiR
LOS L03 ANGELES V
WM J. FOX.CHIEFvwln[sR INUM
NATURE OF INSTALLATI PERMIT NO.
ROUGH ►rxruREs coMFL[T[ _ S-
HEATER CEHROOL SPTIC TANKR[CEVm BY READY FOR DATE ItlUm
ST INSPECTION
FIR
R PT
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
NAME JOB
ADDRESS // ale
R ADDR[BS LOCALITY
i
TEL NO I CROSS ST
COUNTY
CERT No EXPIRES �' NAM[
LOCATION OF SEPTIC TAN$ OR CESSPOOL I MDDAIL
ARESS
NORTH O
CITY NO
1 AM THE LEO POSSWSOR OF THE ABOVE LDS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION
RYYFq
I AN THE LEGAL OWNER OF THE PROPERTY D96CRIMM
ABOVE
owR
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK i
ATH TUB FURNACE
0
xOW[R DISHWASHER 4
VATORY REFRIGERATOR
ITCNEN BINK WATER SOFTENER
R BINK RLND TRAP
LOP SINK OOR DRAIN *a
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DAT[ IKFP[GTOR•N mz
WATER HEATER DENTALLAVATORY
ROUGH PLUMBING
[TRO OAS --------SODA FOUNTAIN 6AB PIPING
OUTL
OAS VENT
c[BGPooL
TOTAL NUMS[R OF PIXTURM SEPTIC TANK
C[SSRDD�_E'fIC TANK f SEWER
S
TOTAL FEE V d UTILITY CO NOTIFIED