HomeMy Public PortalAbout6233 1/4-6233 1/2 TEMPLE CITY BLVD_Plumbing__ TSASST-CESSIT A-EA
APPLICATION FOR PLUMBI E_R IT
COUNTY OF LOS ANGELES
DEBP�A]�R,pT�T�pTNO}y�pF COODUN�Ty+Y}C�G24M �D>l> e
JORN A LAMtlIE OC: UNTY tNO1N[[R
WILLIAM A JENSEN Sur T OF Bu1LDIII Na
FOR APPLICANT TO FILL IN CES BT
NUMBER FIXTURE OR ITEM EACH FE[ Owmm
WATER CLOSET 11 25 NAM
BATH TUB 1 TS DRESS
SHOTPa 125
LAVATORY 125 ! CONTRACTOR TEf No
SINK I23 J ADDRESS
52
DOHWABHEB 125CITY ISTMTEL NO to /
TRACTOR
LAUNDRY TDB 125 REOTION J
NO .i COOIYY
CLOTHES WASHER 125I DIRT ICT NO O 20'N[ P OC[S Y
WATER HEATER 1 W o--p
USTFUL
OAS SYSTEM_ OUTLETS 1 Q WWAASTE APPROVAL O
OUTLETS OVER S PER SYSTEM 20 INSPECTION RECORD V
�O
7L Z
,a,fir, , p� .+.. —
APPROVALS PATE INSPECTOR S 810%1T ¢
PERMIT i y 00 UNDER SLAB WORK V76 14 3
ROUGH PLUMBING
TOTAL FEE GASPIPING
1 HENDRY ACKNOWL[Da[ THAT I HAVE READ THIS APPLICATION GASVENT
AND STAT[ THAT THE ABOVE 10 CORRECT AND ACME TO COMPLY
WITH ALL COUNTY ORDINANCES AND [TAT[ LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEI�r CERTIFYrMAr I AM P110Puv I![aIST¢Rc0 wgOIOR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STAT[ OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
"SIM IN THODE AROV[ KRu[D REA RrY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITT l� f
FINAL 'S A
C ROBERT A WOOD
CK M 0 u
CK M o ¢H SUPERVISING MECHANICAL ENG R
L iI D 4 3 9 ?C' AUB 6 5 D 2 8.05
TSABST•CHS817 4-64. �oe"
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT p�OF COUNTY ENGINEER
JURMG AFilg SAFETY IMION AUDR�BG
JO A L IE COUNTY ENGINEER
R B STATE
WILLIAM A JENSEN SHP T w SuILDING LOC
OR APPLICANT TO FILL IN CROSS
NUMBER FIXTURE OR ITEM EACH FE[ OWNER
WATER CLOSET 9125
BATH TUB 125 DAD BMS 11��4
SHOV"M 175 ,e TEL No
LAVATORY 125 coNraxcxoe
SDYI 115 ADDRESS
DISHWASHER 125 CITY ,t!—eQA��t�b TEL NO/,/ 7u /6
LAUNDRY TDB 175 REGISTRATION
� NO I •7 S� /S COUNTY
CLOTHES WASHER 115 DISTRICTO GROUP Z N[ P ESB[D BY
WATER HEATER 1 5.
Y
GAS SYSTEM OUTLETS 1 50 nmusWASTE LJLLL O
OUTLETS OVER 5 PER SYSTEM 5. INSPECTION RECORD V
DC
O
d
h
Z
APPROVALS DATE INSPECTOR a SIGNATURE
PERMIT Z y 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING 1 .T
I H:RERY ACKNOWL OGK THAT 1 HAV[ READ THIS APPLICATION GAS VENT S f y \
ANO STATE THAT THE ABOVE 1/ COR"CT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND RATE LAWS REGULATING HOT WATER HEATER Y
PLUMEINO
I HEREBY CERTIFY THAT 1 AM PROPERLY REGIRERD AND/OR PLUMBING FIXTURES/
ucENBED AS REQUIRED BY LOS ANGELES COUNTr AHD RATC or
CALIFORNIA OR THAT I AM THE "GAL OWNER OF AND IMTCNO TO GAS TEST
RESIDE IN THE ABOVE DE .590 RESGI[NT1 Pw0 UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL Al
AMt 0 ROBERT A WOOD
CK o CASH SUPERVISING MECHANICAL ENG R
LI ,o 5 5 5 2 SEP 14 131 D 3.2 5~ <
- I