HomeMy Public PortalAbout5300 BALDWIN AVE_Plumbing__ (2) 76A667 (CE-817) - 5/73
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING - q
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY„
FOR APPLICANT TO FILL IN (PRINT OR TYPEI NEAREST �y
CROSS ST. r" f 1
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1.7,.5 _
MAIL
BATH TUB 1.1�5 ADDRESS
SHOWER 1.+5 CITY TEL. NO. f
LAVATORY 1.75 CONTRACTOR
SINK 1,75 ADDRESS u; i/rf
DISHWASHER 1.75 CITY TEL. NO..f
CLOTHES WASHER 1.75 STATEf LIC
LICENSE NO. T. CLASS C `T
SWIMMING POOL RECEPTOR 1.y5
-DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1.15
INDUI �
WASTE APPRO
OVAL v
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD �_
OUTLETS OVER 30
5 PER SYSTEM
O
o_
LV
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR 9 51 aNAT:;RE
Plan check applicant UNDER SLAB WORK
Name dam✓ ROUGH PLUMBING
( ,A 4CSS J l GAS PIPING
City l.y7FJ/ ��. _ Tel. No—/ �.� .r � (, /, GAS VENT
�JJ HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATU RE
OF PERMITTEE
bmimlim a. PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
/ u . .. �.► :► ii r a.