HomeMy Public PortalAbout6131 TEMPLE CITY BLVD_Plumbing__ 7;SCE@Y
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APPLICATION FOR PLUMBING PERMIT :
COUNTY OF LOS ANGELES
-DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS t 3
WILLIAM A:JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST j
CROSS ST. i
NUMBER FIXTURE OR ITEM. EACH FEE
^ OWNER
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WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
r SHOWER1.25 CITY TEL. NO.,
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LAVATORY 1,2 CONTRACTOR'
( SINS 1,25 ADDRESS .
DISHWASHER 1.25 CITY TEL.NO.
LAUNDRY TUB 1 CONTRACTOR'S STATE
REGISTRATION NO. COUNTY
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P ESSED BY
WATER HEAER ��++ 1.50INDUSTIiIAL
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GAS SYSTEMS OUTLETS 1.50 WASE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
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' �•p - APPROVALS DATE-, INSPECTOR;S/SIG_NATURE'
UNDER SLAB WORK
PERMIT $ 21-00 7' / Ila ,.��N'
ROUGH PLUMBING
TOTAL FEE S d GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANGOR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANO STATE OF d/) y/,j /
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CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO. .GAS TEST 16 I R ;✓
RESIDE IN,THE ABOVE DESCRIB RESIDENTIAL PROPERTY. - UTILITY CO.NOTIFIED
LS�IGNATUREE PERMITTEE FINAL
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�LIDATION ROBERT A.WOOD
M.O. CASH SUPERVISING MECHANICAL ENG'R
LAL0 5 8 81 �i;:d 1? 5 D 1 5.r) 0 N a