HomeMy Public PortalAbout6411 TEMPLE CITY BLVD_Plumbing__ 76A667(CE-817)- 7/73
• APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING /J
MAKE CHECKS PAYABLE TO ADDRESS
HARVEY T BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM ® F
OWNER
WATER CLOSET 1 75
MAIL /J
BATH TUB 1 75 ADDRESS b^71 S� Q fl-
SHOWER 1 75 CITY TEL NO 3
LAVATORY 1 75 CONTRACTOR S ABOof
SINK 1 75 ADDRESS
DISHWASHER 1 75 CITY TEL N
CLOTHES WASHER 1 75 STATE LI
SWIMMING POOL RECEPTOR 1 75 LICENSE NO C 55
LAWN SPRINKLER SYSTEM 1 75 Ug q;II IgC�T NO P O E R CESSED BY
WATER HEATER 1 75 WASURTRP MOVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD U
OUTLETS OVER 30
5 PER SYSTEM
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LL
N
2
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
22,
TOTAL FEE
APPROVALS DATE INSPECTOR a SIGNATURE
Plan check licant UNDER SLAB WORK
Name ROUGH PLUMBING
Address _ / GAS PIPING �lO
City TBI NO Q GA$ VENT
HOT WATER HEATER
I H !SY A NOWLEDO[ THA 1 RAVE READ TNI[ APPLICATION
AND STATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES �r 1
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
M.UMSING GAS TEST
I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED SY LOS ANSE ES COUNTY AND STATE OF
CALIFORNIA OR TNAT i AM TX LEO 1G WHER 0 AND INTEND TO
REDID! IM THE AS OV[ DEDCRIS RES NTIAL 0 ERTY FINAL Y
SIGNATURE
OF PERMITTEE
PERMIT v�41DATION CR 0 CASH
PLAN CHECK VALID TI N CK M D CASH ` A
522LAPR 4 5 0 1 7.00 ��