HomeMy Public PortalAbout6350 TEMPLE CITY BLVD_Plumbing__ 745AG87-CER817 I0-02
APPLICATION FOR PLUMBING PE MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGWEER BUILDINGB ollpaG AND S.�FETY DMSION ADDRESS 3 O
JO N A LAMBIE o..rr ENGINEER
WILLIAM A JENSEN SUIT OI BUILDING
LOCALITY
FOR APPLICANT TO FILL IN IfP1P9a
CA089 9T
NUMBER FIXTURE OR ITEM EACH FEE g. DwxER
WATER CLOSET $115 Rj MAIL
BATH TOB 175 •f j ADDRESS
SHOWER I25 I' CITY TEL NO
LAVATORY 175 50 CONTRACTOR ��II �.
SINK 1 7s ADDRESS IE-6 Jr
DISHWASHER 175 CITY TEL NO -oo78
LAUNDRY TOB 175 CONTRACTORS STATE
REGISTRATION NO 7 COUNTY
CLOTHES WASHER 125 DISTRICT NO GROUP Z E BED SY
WATER HEATER 150
CAS SYSTEM OUTLETS 1O WASTE APPROVAL O
OUTLETS OVER 5 P® SYSTEM 20 RR3PECT701 HECOHD U
O
1 ���J'� W
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APPROVALS DATnn INSPECT RBBIGN
PERMIT j 2 00 UNDER SLABWORK
/� ROUGH PLUMBING
TOTAL FEE GAS PIPING '7 `U
I HERESY ACKNOWLEDGE THAT 1 HAYS R<AD TNIa APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY n/
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED aY LOS ANGELES COUNTY AND STATE OF GAS TEST
GLI FOBN IA OR THAT I AM THE LEGAL OWNER OP AND INTEND TO
REWDE IN THEA E D Rlem 11
R"IDENTL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
AMATION ROBERT A WOOD
cR M G CASH SUPERVISING MECHANICAL ENG R
LJ7437V. JAN11 5 D 1625' }
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