HomeMy Public PortalAbout5302 TEMPLE CITY BLVD_Plumbing__ v� DES 17 .I•ED "PLICATION'T FOR Pte'
DEPARTMENT OF IIAND SAFETY PLUMBING
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COUNTY LDS 08 AN ANGELES
WILLIAM J.. FFFOX. OMI[I ENGINEER
OR APPLTO FILL IN (s— 2
PLUMBER EIV[D �. pUDY FOR DAT[ IBBUED
/ rINET INSPECTION 3 _�
ADDRESS
BUILDING ? O A
CITYT[L No o ADDRESS
COUNTYLICKHRE N B \ 17 LOCALITY
NEAREST -
PEHMIT FEES CROSS BY
nUMR[n T Z or riX M on ITEM FE[ OWNER
MAIL
WATER CLOSET(TOILET) @ D So B ADOR[SS I
BATH TUB @ O SO CITY An
4ef TEL Nm
SHOWER @ O SO I1 HEREBY AOKNOWL[DB[_THAT 1 HAVE REAM THIS
-LAVATORYT TPIK ABOVE IS BORRK13T
(WASH BASIN) @ Can
APPLICATION
j O AGRTEE TO COMPLY WIT14 ALL COUNTY MINANOEB
KITCHEN BINK @4 O SO AND BTATE LAWS R[BULATINS PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY @IDSD ANGELES COUN LIC[NSG OR I AM THE LEGAL ONTIER
Or THE R[SI Or P [STY BED �BOVL
GAB SYSTEM OUTLETS @ D SD
SIGNATURE OF I
WATER HEATER @ O, PERMITT[
SLOP BINK x'11 @ can RECORD
►LOGS SINKt' - @ GSO
fl
rLOOR DRAIN @ Dan -/y I
DISHWASHER @ O.SO
DRINKING rCUNTAIN @ O SO --�--`
URINAL @ ago d• t
HOUSE SEWER e CEO Z_
MISCELLANEOUS 19
B
0
APPROVALS
DATE IM R9 NAM[
ROUGH PLUMBING
GAB PIPINGZ
BAB VENT
CESSPOOL • Ica CESSPOOL
SEPTIC TANKI SEPTIC TANK
DRAIN ( ) PIT ( I @ 100 SEWER
PERMIT I OO GAB TEST �—• 11
UTILITY CO NOTIFIED
TOTAL FEE B 6 �� �
TSAe\s/cES17 5/70 `
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER F=ADDD
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BUU.DING AND SAFETY DIVLSIONd
JOHN A LAMBIE. COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING Y
FOR APPLICANT TO FILL IN PR NT OR TYPE) EOSS
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 150
BATH TVR I50
SHOWER 150 NO
A
LAVATORY ISO CONTRACTS
SINE 1 50 ADDIUMS
DISHWASHER 150 C1TT TEL NO O
CLOTHES WASHER 150 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50 DI/t-- CT Na' / ORO P 2 P BY
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER qDUSTXLAL
APPIOVAL
GAS SYSTEM OUTLETS 150 BNRPECTION RECORD
OUTLETS OVER w ,
5 PER SYSTEM 30
i
PIaR check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE E L
TOTAL FEE J APPROVALS DATE INSPECTOR•SIGNATURE
PIeR check applicarit UNDER SLAB WORK
NEDe ROUGH PLUMBING
Address GAS PIPING
GAS VENT
Gl[y Tel NO HOT WATER HEATER
1 HRNEEY AC[NDWLIDO[ THAT 1 HAVE READ TNI[ AEFLIGTIOM
AND STAT[ THAT THE ADOVE IS CORRECT AND AGREE To COMPLY PLUMBING FIXTURES
WITN ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING GAS TEST
Ptue .O
1 MumY CERTIFY THAT I AM PROPERLY AEGEPED TEANDIOR UTILITYCO NOTIFIED
LICENSED AS REQUIRED BY LO[ ANGELESU
COUNTY AND STAT[ OF
GUFORHIA OR THAT I AN THE MOAL OWNER o AND INTEND TO
RUID[ IN THE AWPE GSC EED RESIDENTIAL P Fry FINAL U
SIGNATURE
OF PERMITTEJACK R. ALLEN, DU VI91N HAHICAL ENG R
E
PERMIT VALID ON cK M o CASH
PLAN CHECK VALIDATI c,< M o CASH -
J.r" I'to65;2 SEP 27 5 D 4.75- Q