HomeMy Public PortalAbout5733 TEMPLE CITY BLVD_Plumbing__ 76A667 8-
817 8-SR APPLICATION FOR PLUMBING PERMIT 1 ,
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BUILDMG AND SAFETY DIVISION
Department of County Engineer.
County of Los Angeles BUILDING
JOHN A.L.AMBIE,COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUPT OF BUILDING /J
LOCALITY —Iir�SG
FORJJ�'APP//LI1ICANT TO FILL IN I NEAREST
ROSS t. VI'
OWNER IG//Iv/D I,i*A--4r4 DISTRICT Nj0j GROUP ZSLNE READY FOR INSPECTION
MAIL
ADDRESS -73
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r INDUSTRIAL
CITY CITY �1TEL.NO/./� WASTE APPROVAL I
PLUMBER C<IG° lamp' d C o NT OE) MSPECTION RECORD
ADDRESS1-4` / v +
CITY 7-- 4r. TEL.N922!i —ell I✓/
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00•
WATER HEATER @ $I..00
GAS SYSUM @ $1.00 O
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APPROVALS
DATE INSPECTOR'S SIGNATURE_
UNDER SLAB WORK
PERMIT $ 1' 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE d .
GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 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 To
PLUMBING FIXTURES.
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIEDICs
DESCRIBED RESIDENTIAL P RTY "
SIGNATURE [/
OF PERMITTEE FINAL
ROBERT A.WOOD,
JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION SUPERVISING MECHANICALENG'R
CIC
N.0. 1 CASH
�r!1�0 2 4 i-Lr. JUL 16 3
2.0 0
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