HomeMy Public PortalAbout6028 TEMPLE CITY BLVD_Plumbing__ 78ABB7-CE817-11-57 �
APPLICATION FOR PLUMBING PIERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING Q
JOHN A. LAMBIE, County En es
TT D. GRIFFIN,Supt of wilding
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. W
NUMBER FIXTURE OR ITEM ti
WATER CLOSET OWNER zy,
BATH TUB ADDRESS(o.5
SHOWER CITY TEL. 1 6.(0
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY TEL.NO.
LAUNDRY TUB CONTRACTOR'S STATE [:]IREGISTRATION NO. COUNTY
CLOTHES WASHER DISTR0., GROUP ONE READY FOR INSPECTION
WATER HEATSB ei� X
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
r
APPROVALS
@ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
Olt FIXTURE $
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I. HAVE READ THIS APPLICATION
GAS VENT
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY HOT WATER HEATER ,j •��)� /Q
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING '•
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED.:AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OFPERMITTE FINAL s" �lAf�6
ROBERTA.WOOD.
OF TALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0. CASx
172.7tR JM12 5 A 3.00