HomeMy Public PortalAbout6006 TEMPLE CITY BLVD_Plumbing__ 76A667-CF#817 2-62 TEMPLE HTIT
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION • BUILDING /f
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS (fAV
WILLIAM A.JENSEN. SUP'T OF BUILDING LOCALITY
FOR APPLICANT TO FILL'IN NEAREST .
CROSS ST.
NUMBER FIXTURE'OR ITEM EACH FEE
OWNER ` '
WATER CLOSET $1.25 MAIL'
BATH TUB 1.25 ADDRESS a �`
SHOWER 1.25 CITY 1 ' TEL NO,
LAVATORY 1,25' CONTRACTORIf
SINS 1.25 ADDRESS
DISHWASHER 1.25 CITY a TEL. NOff, f� �
LAUNDRY TUB 1,25 CONTBAC A'S n STATE
AEGISTR ON NO. �f COIINTY
CLOTHES WASHER 1.25 DICT NO. GROUP Z•NE P SSED BY]
WATER HEATER 1.50 L
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL I
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
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_ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING _
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/on PLUMBING FIXTURES 1
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM HE LE L OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DES IBE ESIDENTIA PROPS Y. 'UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL b�7
VALIDATION--, ROBERT A.WOOD
CK. M.O. CASH SUPERVISING.MECHANICAL ENG'R '
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