HomeMy Public PortalAbout4824 1/2 BALDWIN AVE_Plumbing__ (2) 78A 887 CE#817 5/63 � f--
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 1
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 82 -- N. Baldwin Ave.
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET Sl ZS OWNER p Edwards
MAIL
BATH TUB 1 25 ADDRESS 828 No Baldwin Ave.
CITY (' TEL NO G1 2
SHOWER 1 25 Te=le
LAVATORY 125 CONTRACTOR
, Installers
SINK 125 DDRESS10920 1 Grand
DISHWASHER 125 CITY Temple Git TEL NO 442-1234
LAUNDRY TUB 125 CONTRACTORS STATE
218
REGISTRATION NO U8 COUNTY I
CLOTHES WASHER 125 191111N�10
DISTRICT NO GR UP ONE P SED BY
WATER HEATER 150 I (�$ --l r
�- GAS SYSTEM OUTLETS 150 14,50 INDUSTRIAL CL
WASTE APPROVAL O
OUTLETS OVER S PER SYSTEM 30 V
INSPECTION RECORD
a
O
F-
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Z
APPROVALS DATE .INSPECTORS SIGNATURE
PERMIT 5 2 00 UNDER SLAB WORK
TOTAL FEE
ROUGH PLUMBING
I HEREBY ACKNOWLEDGE THAT I HAVE GAS PIPING
READ THIS APPLICATION GAS VENT ��7f4� r /
Lw
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST -'--"
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBE RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE L
FINAL
VALIDATION ROBERT A WOOD
cK M O CASH SUPERVISING MECHANICAL ENG R
t
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