HomeMy Public PortalAbout5209 BALDWIN AVE_Plumbing__ (2) 76A667 CE4817 6 65 6'/ / &
APPLICATI N FOR LUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING
LOCAL
FOR APPLICANT TO FILL IN Naos ST
ST
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET $125 MAIL
OWNER U ����
BATH TUB 125 ADDREss6J 2O /Y�&,0L.6G(}/n/
SHOWER 125 CITY�jJJ�oLE TEL NO
LAVATORY 1 25 CONTRACTOR �<'�F C TigLL S
SINK 125 ADDRES ND
DISHWASHER 125 CITY 72!— L- r TEL NO 0`f()
STATE LIC
LAUNDRY TUB 1 25 LICENSE NO CLA
CLOTHES WASHER 125 DISTRICT NO GROUP ZONE P OCESS1D BY
WATER HEATER 150 'o
, r
GAS SYSTEM OUTLETS 1 SO INDUSTRIAL 0
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD V
DL
O
V
W
a
H
Z
A
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
L
ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGHOT WATER HEATER
NGREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
ED ASREQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
RNIA OR AM THE LEGAL OWNER OF AND INTEND TO
INTH ABO D BED ESID NTIAL PROPERTY UTILITY CO NOTIFIEDTURE � f—
ERK
FINAL � ��,✓ ',w�
ALIDATTON
CK M O CASH
LALO 9065 JUN 14 5 D 350-
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