HomeMy Public PortalAbout5918 TEMPLE CITY BLVD_Plumbing__ 76A667-CE 817468
APPLICATION FOR PLUMB NG PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ■-
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST.
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
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WATER CLOSET 1.50 OWNER
MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY TEL. NO.
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS 4.f
DISHWASHER 1.50 C TE
CLOTHES WASHER 1.50 STALIC
LICENSE NbllZa� CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT N GROUP ZONE P BY
LAWN SPRINKLER SYSTEM 2.00 r D 96
O
WATER HEATER 1.50 INDUSTRIAL WV
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 V INSPECTION RECORD 0
OUTLETS OVER 30 0
5 PER SYSTEM
W
Oe
N
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING -71-
Address
Address GAS PIPING E'y
GAS VENT
City, Tel. No. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING. _
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTI P OPERTY FINALE �+
SIGNATURE JACK R. ALLEN, SUPERVISIN ` CH ANI CAL EN'G'R.
ION CK.
OF PERMITTE �
' PERMIT VALIDATM.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH I
Ur, 0 7 8 8co' JUL 3 5 D j.50"'