HomeMy Public PortalAbout4952 TEMPLE CITY BLVD_Plumbing__ ICAeeT
,ee 171005 APPLICATION FOR PLUMBINGP�oR
DrMON OF B=ING AND SAFETY Sj
Department of County Engineer
County of Las Angeles BUILDING
JOHN A L.AMBIE COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP TOP BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OWNER DISTRICT NO GROUP ZONE RCAOT MR INnaoTION
MAIL ✓
ADDRH89
INDUSTRIAL
CITY TEL N 1
WASTE APPROVAL
PLUMBER INSP=ON RECORD
ADDRESS / 2-40
CITY TEL NO
LICENSE NO Q
NUMNKRI TIT[OF FIXTURE ON ITEM FEE
WATER CLOSET (TOILET) Q $t oo S
BATH TUB 100
SHOWER Q v 00
LAVATORY (WASH BASIN) @ $100
KITCHEN SINK $1 00
DISHWASHER @ $I 00
LAUNDRY TUB OR TRAY @ $I OO
CLOTHES WASHER @ $1 00
WATER HEATER Q $1 Go
GAS SYSTEM 2100
APPROVALS I
DATE INSP TOR S SIGNATURE
UNDER SLAB WORK
PERMIT ti 1 00 ROUGH PLUMBING
OAS PIPING
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES l
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND §TATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED 10 1
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE M
OF PERMITTEE f"idbPINAL
JOHN A LAMBIE, COUNTY ENGI R ATION ROBERT A WOOD CHIEF PLBG INSPECTOR
OK ■ G "FK
985E JU! 3 900 U)
l.,