HomeMy Public PortalAbout5102 TEMPLE CITY BLVD_Plumbing__ 78 A 887-CE 017 438 �
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES IJ
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION SBDDB1a
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOC
FOR APPLICANT TO FILL IN PR NT OR TYPE C
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 150
NAIL
BATH TUB 150 ADD
SHOWER 1 50 TEL NO
LAVATORY 1 50 CONTRA
SINK 1 50
DISHWASHER ISO TEL NO O d
CLOTHES WASHER 1 SD STATE LIC
LICEN6i NO CLASS
SWIMMING POOL RECEPTOR 150
DISTRICT NO OIspUP ! PR ESSED SY
LAWN SPRINKLER SYSTEM 7 00 1 1
WATER HEATER 1 50 IV 04DUMWJLL vo
WASTE APPROVAL
N�BTECTION RECORD GAS SYSTEM OUTLETS 150 O
OUTL
55 PERETS SYSTEMR 30
W
Plan check fee 21,% of above See reverse
PLUMBING PERMIT ISSUING FEE S 00
TOTAL FEE
APPROVALS DATE INPTCTOR Y SIGNATURE
Plan Cheek applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel NO HOT WATER HEATER
1 H[R[[Y ACKNOWL[OO[ THAT 1 HAV[ READ THIS ATlIGT10M
AND STAT[ THAT TH[ ASOV[ IS coRR[CT AND AORR TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ONDINANC[s AND STAT[ LAWS ARGULATING GAS TEST
PLUMSINO
I HI my
CKWJ" THAT I AM PIIORRLY REGISTERED AND/OR UTILITY CO NOTIFIED
ucENe[D AS R[oulR[n BY LOS ANO[L[S couNn AND STATE OF _
CALIFORNIA OR THAT 1 AM THi LEWL OWNER Or ANO INTEND TO
RUIO[ IN TH[ASOV[ IECD RESIDE I PROP[Rry FINAL
SIGNATURi JACK R. ALLEN, SUPERVISI HANK NG'R
OF PERMITTEEIf 9-
PERMIT VALIDATIO cK M o CASH
PLAN CHECK VALIDATION CK M G CASH
7 6 1 I-IS 5 0 3 Z 0 Q
4