HomeMy Public PortalAbout9563 WOODRUFF AVE_Plumbing__ ,'76A667-CE81712/59 TEMPLE CITY
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
" DEPARTMENT OF COUNTY TGINEER
B�ITIT.DINCiEJSA�FETY SION BUILDING
OHN A. BI OUY INEER ADDRESS
WILLIAM A.JENSEN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT'TO FILL IN NEAREST
ST.
CROSS
NUMBER FIXTURE OR ITEM CROSS
WATER CLOSET MAIL
ADDRESS DO I
BATH TUB
SHOWER ClT> TEL l
4k
CONTRA• OR
LAVATORY
Snm ADD88S8
DISHWASHER CITY TEL N
CO TRA OR'S STATE
LAUNDRY TUB REGIS TION N.O. �/ COUNTY p
CLOTHES WASHER DISTRICTNO. 4?$OldPr ON. MPOS HY
WATER HEATER , .o
GAS SYSTEM INDUSTRIAL
WASTE AMOVAL
J INSPECTION$ECORD Z/
Rd
0
FA
rA
/ ! $1.U0 PER ITEM r OP
OR FDCTURE. $ I ! APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE G+O ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGETHAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE I8 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AMD STATE .LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I, AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST r f
CALIFORNIA OR THAT I M T E LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIA OP IY. O A UTILITY CO.NOTIFIED i)14
SIGNATURE t/ '!/ A rI 1 W 41.XLI
OF PERMIT[E ad= FINAL V
�e VALIDATIO ROBERT 1A.VVOOD,
ell. M.O. CpsR SUPERVISING VECHANICAL.ENG'R
7545 -JAN 29 5 0 3.00 M