HomeMy Public PortalAbout5925 TEMPLE CITY BLVD_Plumbing__ V . C
76A667 (CE-817)-4/72 ,s -
APPLICATIO OR PLM`BING PERMIT
COUNTY OF LOS-ANGELES. .
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION.
AIAKE CHECKS PAYABLE TO: BUILDING /f;-. l��
ADDRESS C:��
HARVEY`T. BRANDT, COUNTY ENGINEER LOCALITY' -'�
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FOR APPLICANT TO FILL IN (PRINT OR TYPE). NEAREST
NUMBER FIXTURE OR ITEM 0FEE CROSS ST.
WATER CLOSET 1.75 • OWNER14,11Al;
MAIL
BATH TUB 1.75 ADDRESS
SHOWER 1,75 CITY L. NO.
LAVATORY 1.75CONTRACTOR
SINK 1.75 ADDRESS`
DISHWASHER 1.75 CITY TEL. NO.
CLOTHES WASHER 1.75 STATE. /� LIC
LICENSE NO. D CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP ZONE FR ESSED BY
LAWN SPRINKLER SYSTEM 1.756;409 p ,L
WATER HEATER 1.75 INDU PIAL
WASTE APPROVAL O
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD y
OUTLETS OVER a
5 PER SYSTEM .30
CD
Plan
000.77
h
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3.100
TOTAL FEE
APPROVALS DATE INSPECTOR'•S SIGNATURE
Plan check applicant UNDER SLAB WORK.
Name ROUGH PLUMBING
AddreSS ��. - =� GAS PIPING
City Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY 'ACKNOWLEDGE THAT I 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
PLUMBING, 'GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS RECIUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM HE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DE RI 'ED (DENT L .ROPERTY. FINAL
r
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION cK M.O. CASH
PLAN CHECK VALIDATION CK. M.Off CASH
2.-4 6 r0G3 7 5 U 4.7 5 A