HomeMy Public PortalAbout5520 TEMPLE CITY BLVD_Plumbing__ 78AW-CES17&59
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGIIIEER
BU11MING AND SAFETY pD�MSSlON DIN IN
CMT A.D OHD'6 B��t et 9 admg
WCALITT
FOR APPLICANT TO FILL IN CROSS T
NUMBER FIXTURE OR ITEM '
ST
OWNER
WATER CLOSET yMa
J RATH TDB ADDRESS
CITY TEL NO.
SHOWER
LAVATORY CONTRACTOR
SaE ADDRESS
DISHWASHER CITTTIS. N0. / 3
CONTRACTOR S
LAAfImRT TDB REGISTRATION NO / COUNTY
CLOTS WASHER DISTRICTNO GROUP ON6 P ED BY
WATER HEATER `7/
GAR SYSTEM ffiDIISTRIAL
WASTE APPROVAL
INSPECTION RECORD
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b
TEM
/0 O��tt 80°PII�T08R f yp
APPROVALS DATA INSPECTOR B SIGNATURE
PERMIT S 2100 UNDER B WORK
TOTAL FEE 0 ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS BEOULATINO
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE rV
DESCRIBED REBIDTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURERMITTE
OF PE
L�= FINAL L
Or ALIDATION ROBERT A WOOD,
Q M G. taNa SUPERVISING MECHANICAL ENQ'R
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