HomeMy Public PortalAbout4924 TEMPLE CITY BLVD_Plumbing__ r 7
76A667-MU-8-58
APPLICATION
ATION FOR PLUMBING PERMIT
COANGELES
UNTY 1
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION l� R ss 2 `
JOHN A. LAMBIE, County EnS5�Paaeer
CASSATT D. GRIFFIN,Supt of BuIldinq LOCALITY t '
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
-v WATER CLOSET / BUM
I SATE TUB ADDRESS
SHOWER CITY f T'EL NO.
LAVATORY CONTRACT&I
SINE /�j=�IC ADDRESS
DISHWASHER CITY TEL. NO.
LAUNDRY TUB CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY
CLOTHES WASHER DIS]r NO. GROUP ZONE "15,bESSFEBY
WATER HEATER - cQLC
GAS SYSTEM INDUSTRIAL '
WASTE APPROVAL
INSPECTION RECORD
—i C_ 'S
J / .-J T /12�ZP
K! �
APPROVALS
.� ER ITEM
OR FIXTURE $ 5 DATE INSPECTOR'S SI ATURE
UNDER SLAB WORK E5r -_'
PERMIT $ 2 00 ROUGH PLUMBING Lqw
TOTAL FEE — GAS PIPI NO
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP KATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROP TY.
SIGNATURE FINAL
OF PERMITTE
®� `r �R.OBERTA.WOOD.
VALIDAYIOUPERVISING MECHANICAL ENG'R
CK. M.O. CASH
X3638r I;i18 5 A 7.00