HomeMy Public PortalAbout6322-6324 TEMPLE CITY BLVD_Plumbing__ T.A..TA ISG°'TAPPLICATION FOR PLUMBING PERMIT
BUILDI AND SAFETY SI Lot #8
FOR APPLICANT TO Flll IN(PRINT OR TYPE( BUIL
gDDRF55 6 le Ci Blvd,
NUMBER FIXTURE OR ITEM a FEE
WATER CLOSET LOCALITY TB Cit
BATHTUB NEAREST V•�
CROSS ST
SHOWER 615 OWNER Fairhav6fi Developmmt
LAvgroRYDDRESS 8656 $. Huntington Drive
SINK CITY San GWIftel TEL NO _
9527
DISHWASHER CONTRACTOR Oven
ingo Inc.
CLOTHES WASHER20 BrDe lnmh
ADDRESS 4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR 1�J��
CITYEl CIIIte TEL NO �I+ia/—()078
LAWN SPRINKLER SYSTEM
LIC
STATE AJZ 7t1. CLASS C3G.20WATERHEATER LICENSE NO
GLAJSS`SEY�STEEME 7 — -OUTLETS DISTI;J �J P E ESSED
OPERSYV
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INDUSTRIAL
WASTE APPROVAL C
INSPECTION RECORD
a
PIOn check fee
PLUMBING PERMIT ISSUING FEE E
TOTAL FEE 73 1+4
Plan check appllcanT — -
n
Name APPROVALSC TE ECTOR 5 SIGNATURE
UNDERSLAB WO
Address
ROUGH PLUMBING
Cary Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I"A READ THIS"PLICATION AMD STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE""REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
MOUAED BY LOS ANGELES COUNTY AND STATE OF CALIFORNA OR TIAT I AM THE GAS TEST
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY UTILITYCO NOTIFIED
DIGNATURfi
OF FERM ITTEE FINAL —
P PERMIT VALIDATION (�CK7 Mo CASH
ri 9 31°." 22 5 D 7 3.0 0 A`ns
POLICYHOLDER: —
POLICY NUMBER; Y,(e, /s— 33 S L— O)�p