HomeMy Public PortalAbout5029-5031 TEMPLE CITY BLVD_Plumbing__ nee 17 n-= k_, APPLICATION FOR PERMIT °
DEPARTMENT OFTG AND SAFE}Y PLUMBING i
COUNTY LOS ANGELES
WILLIAM J..OF
LOS FOX, aNlcr [NGINcsR
FOR APPLICANT TO FILL IN N
PLUMBER R§pKIVED BY RST INBPFOTION DATE ISBUED
ADDRESS M O13
OTTY TiL No
A� aill PA. E /3. ✓
ICENB oZ EXPIRES LOCALITY /�/ LGrK
PERMIT FEES o_R=3''T'-/ A05
MYM�q T1T[OF FYRYR[OR ITEM FEE OWNER 45T A A(,4( ID
MAIL
WATER CLOSET(TOILET) @ O BG B 0 U ADDRESS
BATH TUB @ Dam Q CITY TEL No
SHOWER @ Ono I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ Dam () Q APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT
AND AGR[[ TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK —@ OSO Q AND STAT[ LAWS REGULATING PLUMBING
I CERTIFY THAT I POSSESS THE ASOV[ VALID Lou
LAUNDRY TUB OR TRAY @ Dam ANGELES COUNTY LIOENSFy OR 1 AM THE LEGAL R
OF TH[ R[BIDEN ROPERTY�RIB W
GAS SYSTEMLTTLETS @ O BO d 'BISNATURE OF
WATER HEATER @ 050 PERMITTE
BLOP BINK @ O 6O INSPECTION RECORD
FLOOR SINK @ G.SO
FLOOR DRAIN @ OBC
DISHWASHER @ Can —
DRINKING
BODRINKING FOUNTAIN @ 050
URINAL ® Dam J
Q
HOUR[ SEWER @ Dam =
MIRCELLAN[OU a
'V (]
APPROVALS
DAT[ IMq'EOT " NAME
ROUGH PLUMBING
BAB PIPING J'
GAB VENT
CESSPOOL @ IOU CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) @ Ion SEWER
PERMIT 100 a" TEST
UTILITY CO.NOTIFIED
TOTAL FEE t O C7
FINAL T f T L