HomeMy Public PortalAbout6217-6219 TEMPLE CITY BLVD_Plumbing__ mow w 19 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES' KUMBING - .9
WILLIAM J. FOX.. CHIEF ENGINEER
FOR. APPLICANT TO FILL IN: DISTRICTNO. GROUP ZONE PERMIT NO.
PLUMBER t R IVED BY READY FOR DATE ISSU D
FIRST INSPECTION
ADDRESS < � "
i
BUILDING/
CITY TEL. NO.. ADDRESS
COUNTY LOCALITY /
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROs T. .
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNERy
MAIL
WATER CLOSET (TOILET) @ O''.50..ffi ADDR S
Y
BATH TUB @ 0'.50' CI 6 TEL. N /
SHOWER @ 0.50 �
1 HEREBY ACKNOWLEDGE THAT I HAVE RE THIS
LAVATORY WASH BASIN) @ 0.50.I APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK ® 0.50 STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUBO TRAY @ 0.50 ANGELES CO '7 LICENSE. OR 1 AM THE LEGAL OWNER
OF THE REBID NTIAL PROP RTY •ESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 I SIGNATURE OF
WATER HEATER @ O..So PERMITTE
SLOP SINK @ o.soINSPECTION RECORD
FLOOR SINK @ 0..5
FLOOR.DRAIN @ 0.50.
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50.
Q
HOUSE SEWER @ O.SO I. z
MISCELLANEOUS (�
IC
O
I
I
I
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
I
GAS PIPING
GAS VENT ✓
CESSPOOL @ I.Do. CESSPOOL
SEPTIC TANK- I SEPTIC TANK
I' DRAIN ( ) PIT ( .. ). 1.00 SEWER.
PERMIT . • ' I.00 GAS TEST 2-7 }�
UTILITY CO. 'NOTIFIED `1. y A .
TOTAL FEE FINAL
7GA667-CE#817 10w67
APPLICATION FOR PLUMBING. PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERADDFM$ `
BUILDING AND SAFETY DIVISION BUILDIN A21 7
JOHN A. LAMBIE. COUNTY ENGINEER J
COLEMAN W. JENKINS,SUP'T. OF BUILDING LOCAL
FOR APPLICANT TO FILL IN PR NT O TYPE. NEAREST �
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50 MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY TFL. NO.
LAVATORY 1.50 CONTRACTOR O
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY �, O
CLOTHES WASHER 1.50 STATE LIC ry
LICENSE NOoOG CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE P. .CESSED•BY,
d
LAWN SPR LER SYSTEM 2.00 2 O
V
1.50 �J INDUSTRIAL �
WASTE APPROVAL O
S SYSTEM OUTLETS 1.50 INSPECTION RECORD v
OUTLETS OVER 30 y
5 PER SYSTEM
Z
Plan check.fee 25%b of above. See reverse.
PLUMBING PERMIT ISSUING FEE $ 2 00
TOTAL FEE J
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City. Tel. No. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING. .- ....
.1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND ST OF
CALIFORNIA OR THAT 1 AM THE LEGAL.OWN R OR AND D TO e��j
RESIDE IN.THE ABOVE DESCRIBED RE81D T L ROPE FINAL �'�F _
SIGNATURE �,(� JACK R. ALLEN, SUPERVISI HAN1.. L ENG-R. '
OF PERM ITT� PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
Ca
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