HomeMy Public PortalAbout6004 1/2 TEMPLE CITY BLVD_Plumbing__ 76A667-CE#817 2-62
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONTNEAREWST
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JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING
FOR APPLICANT TO FILL IN NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET $1.25 MAILAA
HATH TUB, 1.25 ADDRESS 7P, Q-- L
SHOWER 1.25 CI TEL. N
LAVATORY 1.25 CONTRACTOR s�
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SINS 1.25 ADDRESS.
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DISHWASHER 1.25 CITY TEL.NO. r '�p/
CONTRAC A'S / STATE
LAUNDRY TUB 1.25 /
REGISTRATION NO. JCOUNTY ❑
CLOTHES WASHER 1,25 DISTRICT yD.- GRPRP I ZONE P E SED BY
WATER HEATER 1.50Ul (�J/
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .$0 INSPECTION RECORD
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APPROVALS DATE INSPECTOR'S SIGNATURE ,
PERMIT 5 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 D HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND
NSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I AM
HREBY CERTIFY THAT 1 OPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSEED AS REQUIRED BY LOS GELES COUNTY AND STATE OF 'GAS TEST
CALIFORNIA OR THAT I A TH LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE D R WR'TTIAL OPE UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE7
FINAL
VALIDATION ROBERT A.WOOD
CK. M:O. CASH SUPERVISING MECHANICAL ENG'R
i-Aco 3 7 0 1 t2 DEC 19 5 D 3.5 O~
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