HomeMy Public PortalAbout5853 TEMPLE CITY BLVD_Plumbing__ 76A6B7-CE817 3.59 .
APPLICATION FOR PLUMBING PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS � i
TOHN A.LAMBIE, County Engineer
CASSATT D. GBNTIN,Sup t of Building LOCALITY
FOR APPLICANT TO FILL IN NEARESTI
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNEB� -
WATER CLOSET MAIL
RATE TUB ADDRESS / ✓
CITYO.
SHOWER TEO
LAVATORY CONTRACTOR
SDvB ADDRESS .
DISHWASHER CITijAAA 'fM NO.
CONTRACTQ3fs / ❑
LAUNDRY TUB REGISTRATION NO. (SQ LINTY13
CLOTHES WASHER DISTRICTNO. GROUP /ZONE P SED BY
WATER HEATER
GAS SYSTEM
INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
PER ITEN
OR�FD[TURZ $
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ E 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING _
' GAS PIPING `•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ,. GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY .CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST . D .f Me NO
CALIFORNIA OR THAT 1 AM THE OWNER OF THE ABOVE .
DESCRIBED RESIDENT iERTY. UTILITY CO.NOTIFIED
SIGNATURE ��CC))OO..I�'I a
OF PERMITTER
®P VLIDATIO ROBERT A�WOO4D.
cE.
13.a %� SUPERVIGIN6 I1QECHANICAL EKG'R;
A.f08 1 2 8 5 NOV 2 5 5 A 3.0 0 M