HomeMy Public PortalAbout6339 TEMPLE CITY BLVD_Plumbing__ 76A667AFCE 81761 11/76
r 0 APPLICATION FOR PLUMBING PERMIT it
BUILDING AND SAFETY DIVISION (� 3
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM • FEE ADDRESS 6W 7 40 y(Fisc C/TY
8 W
WATER CLOSETLOCALITY
BATHTUB 0-'V NEARESTCROSSST �.Jp� M�?�
E SHOWER al) OWNER
Z LAVATORY MAIL
ADDRESS 5/7MC
/ SINK CITY TEL NO
DISHWASHER CONTRACTOR /� �pV�/"�g//��
f CLOTHES WASHER ADDRESS syO7 1WA-x7?W=e AvF
SWIMMING POOL RECEPTOR
Ory Aj(sCiQ pi4 TEL NO y y-6839
LAWN SPRINKLER SYSTEM STATE /j / � ^j
WATER HEATER LICENSE NO31-76% 2- CLASS G- J
GASSYSTEM OUTLETS DISTRICT NO GROUPP -ED' GY r
Os�iqrsGrEYM 5 ER ��iy�/
INDUSTRIAL C/ 11116
WASTE APPROVAL 0
INSPECTION RECORD
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414
7 6
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan dwk applicant
Name APPROVALS DATE Rs
UNDER SLAB WORK
Address ROUGH PLUMBING
Gty Tel NO GAS PIPING
I WGE
HEREBY ACHNOLLDTHAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AMD AGREE TO COMPLY W ITN ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I NEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR MENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE W CALIRORMIA OR THAT I AM THE GAS TEST
UE OWNER Of "DOMND T ESIDE IN THE OVE DESCRIBED RESIDENTIAL-
PROPERTY
ESIDENTIAL
PROPERTY UTILITYCO NOTIFIED
SIGNATURE
OFPERMN E FlNAI
PLAN CHECK LIDATION CN M OcAa11 PERMIT VALIDATION CK M D CASH
g APR 26 5 C 3 '75 0 •58
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