HomeMy Public PortalAbout5428 TEMPLE CITY BLVD_Plumbing__ 67
TeaeeT CE=°" 'DAPPLICATION FOR PLUMBI G PERM,, 11
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONJ
88
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDINGITY
FOR APPLICANT TO FILL IN PR NT OR TYPEEST
BT
NUMBER FIXTURE OR ITEM EACH FE
RWATER CLOSET 150BATH TUB 1 so SS
SHOWER 150 Cm TEL R
cl'ov4p'J214
LAVATORY 150 CONTRACT
SINK 1 So ADDRESS
DISHWASHER 1 50 CRY TEL 11O
CLOTHES WASHER 150 STATE .T LIC ----
LICENSE N p CLASS
SWIMMING POOL RECEPTOR 1 50 I ICT NO I Grp ZONE PR E6 BY
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER 1 50 INDUSWASTI LEOVw - C
O
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD U
OUTLETS OVER JO
5 PER SYSTEM
N
- Z
Plan check fee 25% of above See reverse _
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR°aiaNwTUlle
Plan check applicant UNDER SLAB WORK -
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
HOT WATER HEATER
I H MSY ACKNOWLEDO[ THAT 1 HAV[ READ TNI/ ARLIGTION
AND /TATE THAT THE ABOVE 1/ CORM AND ACME TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINAMCK AND STAT[ LAW/ REOOLATINO GAS TEST
PLUMBING
1 HEMBY CKWIPY THAT I AM FROP[RLY REOIEr[IED AND/M UTILITY CO NOTIFIED
LICE
M/ED Al R[OUIRED BY LOS AMOSUES COUNTY AMO STATE OF
CALIFORNIA OR THAT 1 A TH[ LEGAL OWN[R OF AND INTEND TO
RESIO[IN TH[A10V[ MIMED IESID[MTIAL FROM FINAL
SIGNATURE JACK R ALLEN, SUPERVISING MECHANICA NO'R
OPPERMITTi
PERMIT VALIDATION CK M o caeH
PLAN CHECK VALIDATION CK M 0 CASH
Ur„9 3 1 9."G W11 ' 5 0 350~Q'
`�fyi