HomeMy Public PortalAbout5016 BALDWIN AVE_Plumbing__ (2) ' t
76A667 CE$x'817 5 61
APPLICATION FOR PLUMBING PERMIT"
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER /(WILLIAM A JENSEN SUP T OF BUILDING 1,3
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FOR APPLICANT TO FILL IN OR
ST
NUMBER FIXTURE OR ITEM OWNER
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WATER CLOSET KAM
BATH TUB ADDRESS
CITY TEL NO
SHOWER
LAVATORY cONTBACTOBAIec t Plumping & Heating
SINS ADDRESS 13933 So Crenshaw Blvd.
DISHWASHER CITY Havithoz z e TEL NOS 93 691
CONTRACTORS
_
LAUNDRY TUB BEGISMATION NO COUNTY
CLOTHES WASHER DIST CT NO GROUP Z NE P SED BY
WATER HEATER �� iL
GAS SYSTEM �USTR�' V
WASTE APPROVAL
INSPECTION RECORD w A 09
Y1.2 116
V!
z
0o PER ITEM
OR FIRTIIRE $ APPROVALS D
ATEJINSPECTORSSIGN09fIl
PERMIT $ 2100 UNDER SLAB WORK �,—f
TOTAL FEE ROUGH PLUMBING F A&I
GAS PIPING TO ' r
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT r/
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
- /
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES q' I
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM TH GAL OWNER OF THE ABOVE _
DESCRIBED RESIDENTIAL PROP UTILITY CO NOTIFIED U d
SIGNATURE A a . .
OF PERMITTEE FINAL
r.e
VALIDATION ROBERT A WOOD
L`K M o CASH SUPERVISING MECHANICAL ENG R
IPLal 50 11.25- 4�