HomeMy Public PortalAbout4912 TEMPLE CITY BLVD_Plumbing__ 70AEE7C (C&-EITe) -E/TE
APPLICATION FOR PLUMBING PERMIT
(:;� 'O
BU INO AND SAFETY KVS
ION
FOR APPLICANT TO FILL IN (PRINT OR TY PEI BUILDING
DDRESS Iz- T11 LE C,r B��
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY
BATH TUB NEAREST
CROSS ST
SHOWER OWNER G T }ALL
LAVATORY MAIL
ADDRESS '' ``�Z 'SEM �TEJ BAV
SINK CITY '/El)1 )L..E� Cf,Ty TEL NO a.p 6 704 1
DISHWASHER CONTRACTOR b , , �y�Aeg E2
CLOTHES WASHER ADDRESS 766 C . �F1L�ow eiv
SWIMMING POOL Oil CITY A TEL NO -bii
LAWN SPRINKLER YS M CnV i�p �QLIC
' j
WATER HEATER STATE CENSE NO a I �'�`� CLASS L- a O
DIS PICT N R UP NE CES D By
V
GAS SYSTEM OUTLETS 8 „4 t z
OUTLETS OVER DO 0
5 PER SYSTEM Ug U
WASTE APPROVAL H
INSPECTION RECORD i
LI c6 OK
Plan check tee '
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR S RIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel NO GAS PIPING
I HEREBY ACKNOWLEDGE THAT I NAYE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IE CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDI RANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUM p1 NO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALI FO RRIA OR THAT I AM THC LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE 1n'
OF PERMITTEE • a� FINAL
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M G
5 3 1�FEB / 5 0 7.5 0 A=
i o e R-IV 2w MCTM I,Jt ` '" APPLICATION FOR PEFWr
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES .' �L������
WM J FOX,CHIEF QIGINEER I =-
rINAMOF INSTALLATION LHIMRICT NO GROUP I ZONE
I PERMIT NO.
`) ry Q
N
/IIRUR111 COMPLETE � !:ONON
iw 's
CESSPOOL EERIC TANK BY FOR
FTION
APPLICANT FILL IN HEAVE OUTLINED PONLY
d � AADDRESS Y my LOCALITY
No ��' CRROOSS STST.BEEPER NAME
OF SEPTIC TANK, OR CESSPOOL MAIL
ADDRESS
NORTH
CITYTEL NO
1 AM THE LEGAOR OF THE ABOVE LOS
AN06O O NTY COP QUALIFICATION.
M1 AM THE LEGAL HE PROPERTY DES R1111D
ADOM
OWNDI
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK i
ATN TUB FURNACE �
rc
ROWER DISHWASHER O
4-LAVATORY REFRIGERATOR
ITCHEN BINK WATSRBOFTQIER
R SINK RAND TRAP
OP SINK F DDR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INYKTON•NAN•
W
LATER HEATER DENTAL LAVATORY BOUGH PLUMBING v 4 h
ETt 12 nAnR^^A FOUNTAIN
OUTL OM PIPING
OAS VENT
CESSPOOL
TOTAL NUMBER OF FIXES
SEPTIC TANK
ESSPt!t7
TICTANK SEWER qq
UTILITY CO NOTIFIEDTOTAL FEE .�'
l D" 1'" Km '�' APPLICATION FOR PERMITCO
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
�� �
� COUNTY OF LOS ANGELES ®®
WM J FOX.CHIEF EIa1NKEe �®I�
NATUREOF INSTALLATION DISTRICT .
ROUGH FIXTURES COMPLETE
NEATER CESSPOOL ✓ BEPTIC TANK R 6N 0V !PCWDKBSDR
OR DATE ISSUED
CADECTION '``
MI N —d—
APPLICANT FILL. IN IIEAVIL OUTLINED PONLY
NAME ,ADDRESS V
S ADORK88
LOCALITY
NEAREST
CITY T0. No CROSS ST.
COUNTY
CERT No KXPIRES �' NAME ,LOCATION OF SEPTIC TANK, OR CESSPOOL i MAILNORTH ADDRESSTn-No1 AN THE LKOSOR OF THE ABOVE LOS
ANGELES COUNTY O U IFI AM THE LEGALTHE PROPERTY DESCRIB®
ABOVE.
01YMY1
CORRECTIONS
BGUTH
J
DESCRIPTION OF WORK a
z
ATH TUB - FURNACE m
C
OWEI DISHWASHER p
--------LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
R SINK - BAND TRAP
OP SINK F DDR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSKT DRINKING FOUNTAIN DATE IKt►KCIOR rAYK
WATER NEATER DENTAL LAVATORY ROUGH PLUMBING
QTlo SAS A^^A FOUNTAIN
OUTL OAS PIPING
GAB VENT
/ CKSBPOOL
7RTAL NUMBER OF FIXTURES 613-TIC TANK
✓/ ESBPOO, SEPTIC TANK SEWER
S / `O UTILITY CO NOTIFIED
TOTAL FEE
IN