HomeMy Public PortalAbout5522 TEMPLE CITY BLVD_Plumbing__ 7SAW-CW 17 3-39
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPABTNhUM OF COUNTY ENGUaM
BUILDING AND SAFETY DTVISION AD�DR>Bs
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FO8 APPLICANT TO FILL IN NEAeffiT
CROSS or
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSES MAII.
BATH TUB 'ADDRESS
or
SHOWER CITY TEL. NO
LAVATORY CONTRACTOR
MNK ADDRESS
DISHWASHER CRY 7ffi. N0. 4,9
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LAUNDRY TUB REGISTRATION NO 1119 COUNTY
CLOTHES WASHER DISTRICTNO GROUP L4- P ED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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/O R F1 TURE APPROV DATE INSPECTOR II SIGNATURE
PERMIT $ 2 GO UNDER SVreWORK
TOTAL FEE O ROUGH PLUMBING -O tSrZ
GAS PIPING r-
1 HEREBY TATE ACENOW LEDGE ABOVE 12 I NAVE READ TXIS APPLICATION
ANO [TAT[ THAT THE NAIII CORRECT AND ACRE[ TO COMPLY GAS VENT 'L O
PLL ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HHATER
FLUBBING
1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAB TEST
CALIFORNIA OR THAT 1 AN THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY / UTILITY CO NOTIFIED - -
SIGNATURE
OF PERMI
FINAL
mPVALMATION ROBERT A WOOD
CE N 0. QAs SUPERVISING MECHANICAL ENO'R
o . UtCD 0 6 9 4 3 HAY 1 2 5 A 12.0 0 M