HomeMy Public PortalAbout6008 TEMPLE CITY BLVD_Plumbing__ 78A887-CE#817 9/63 �►r�r/� � �'
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APPLICATION FOR PLUMBING PERI�IIIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY 1
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
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1,2.5 CONTRACTOR �
SINS 1.25 ADDRESS
DISHWASHER 1.25 CITY i TEL. NO to1,06 Iii
LAUNDRY TUB 1.25 CONTRA'Ci 'S STATE
REGISTAAT N NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP_ ONE SSED BY
WATER HEATER 1.50
GAS SYSTEM OUTLETS 1:S0 INDUSTRIAL ;a
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
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APPROVALS DATE_i INSPECTOR'55 GI (IATURE
UNDER SLAB WORK
PERMIT $ 2 00 ;
ROUGH PLUMBING
TOTAL FEE GAS PIPING r.
I HEREBY ACKNOWLEDGE THAT 1 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 HOT WATER HEATER ,y
PLUMBING. l 1 • i �.8 ,9 s.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURE�S�,
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 1
CAIBE
ALIFORNIA OR THAT I M HE L I OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DES ESIOENTIAL OPILITY'CO.NOTIFIED
SIGNATURE
OF PERMITTEE A
FINAL
VALIDATIOPV-'1 ROBERT A.V10.OD
CK. .� M;0. /` CASH SUPERVISING MECHANICAL ENG'R
L?,L,o 2 7 4 9 JUN 16 5 D 3.25-