HomeMy Public PortalAbout5031 BALDWIN AVE_Plumbing__ (2) 16 7 10 62
APPLICATION FOR PLU BING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING 13
LOCALITY `
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER '
WATER CLOSET $125 MAIL
BATH TUB 1 25 ADDRESS
/ SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
/ SINK 125 ADDRESS J4
DISHWASHER 125 CITY TEL NO ,5
LAUNDRY fUB1 25 CONTRACTOR S STATE
REGISTRATION NO COUNTY
CLOTHES WASHER 125 DISTRICT NO GROUP ZONE PROCESS 'BV
WATER HEATER 1 50U/
GAS SYSTEM OUTLETS 150 v INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 0
INSPECTION RECORD
OC
*-4—(, 3
LL
` —4-G 3 p lobi JO o7 Aci,- O
H
�/cr,y, 6 �r►a ? p D 1 �,.t�.w,. Lu
W
th
��/ th
Y z
be,
X, APPROVALS DATE INSPECTOR��
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING 4/-'lob �asiiS°�r:xlk.�
TOTAL FEE x GAS PIPING U /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
ANO STATE THAT THE ABOVE IS 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 'U _
LICENSED CALIFORNIAAS REQUIRED M LOS ANGELES COUNTY AND STATE OF GAS TEST
LIFORNOR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
VALIDATION ROBERT A WOOD V
cK M o CASH SUPERVISING MECHANICAL ENG R
LAO 1 6 9 3 Go I^LAR 5 5 D 1 6 25-
v