HomeMy Public PortalAbout5636 TEMPLE CITY BLVD_Plumbing__ oeDEI1710 RR APPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUIMING AND SAFETY
Deportment of County Engineer
County of 1.oe Angeles BUILDING 3 E
JOHN A LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN,SUR T On BUILOIRO
LOCALITYLac C
FOR APPLICANT TO FILL IN NE
CROSS L! Ve O A ICS
OWNER DISTRICT N GROUP I ZONE I READY FOR INSPECTION
MAIL
ADDRESS
L INDUSTRIAL
CITY
TEL NO WASTE APPROVAL
PLUMBER / I p INSPECTION RECORD
ADDRESS W 4
CITY TEL NOS 6 8
LICENSE NO // 3 A/ aQ
NUMBER TYRE OF RI%TUR¢OR REM RES
WATER CLOSET (TOILET) Q $100
BATH TUB sI 00
SHOWER $I 00
LAVATORY (WASH BASIN) C@ $100
KITCHEN SINK 100
DISHWASHER $100
LAUNDRY TUB OR TRAY $100
CLOTHES WASHER •100
WATER HEATER @ sl00
GAS SYSTEM $100
S d
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE GAB VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST .
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY R
SIGNATURE c
OF PERMITTB S FINAL
JOHN A LAMBIE COUNTY ENGINMERVALIDATI0 ROBERT A WOOD CHIEF PLBG INSPECTOR
r - Z4 O rH 2C, JAR 9 3 2.00 �
C>5 - /�
76 A 657 - CE 817 7.69 '
APPLICATION FOR PLUMBI G PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER u°°°a sG
BURRING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN IN JENKINS SUPT of BUILDING
FOR APPLICANT TO FILL IN PR NT OR TYPE RE"ST r
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1 50 NAIL
BATH TUB l SO ADDRESS
SHOWER 1 50 CITY O
LAVATORY 1 50
CONTRA
SINK 150 ADDRESS
DISHWASHER 150 CITT
CLOTHES WASHER 1 50 ISTATIfNSE NOC SWIMMING POOL RECEPTOR 150IGTRIPTN G P ELAWN SPRINKLER SYST 2 00WATER HE 1 50 USTRIAL
TE APPROVAL
GAS SYSTEM OUTLETS 1 50 RISPLCTION SEAQ
OUTLETS OVER 30
5 PER SYSTEM
f
Plan check fee 2S% of above See reverse
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE APPROVALS DATE IN[f cYoP 9 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address OAS PIPING
GAS VENT
City Tel No
HOT WATER NEATER 17
I NSMATS Ac[NowLEODE 15 I NAY[ READ GRI APPUGTON
AND RAT[ TN[T TY[ ADINA IS CORID S AND AOR[[ I LATINO PLUMBING FIXTURES
MTI ALL CAUMT' OROIMANQI AND RAT[ LAWS R[OULATIMO GAS TEST
PLUNGING
I N[ROY C[R1FY "AT I AN PROPERLY R[oIMMD ANO/OR UTILITY CO NOTIFIED
LICENSED AS ROGUIR[D R LOG ANDEIIS COUNTY AND RATE OP
GLIIGNIA OR THAT 1 AN TIQ LEGAL OWM[R OF
AN 1 D M
Gleam IN THE ASOYE DEGCROED mol"It n PROP[RY FINAL
SIGNATURE JACK R ALLEN, SUP ER
OF PERMITT V191N NANICAL EN O'R
PERMIT VALIDATION CK M o CASH -
PLAN CHECK VALIDATION CK MO CASH
I Df, 3 7 8 49 FEB20 5 D -'-5,00"