HomeMy Public PortalAbout5424 BALDWIN AVE_Plumbing__ (2) 76A667 CE817 12/59
APPLICATION FOR P iMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AFETY MSION BUILDIN
JOHN A L M I COUNTY NGINEER ADDRE �-Baldwin Ave.
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY Tem le Cit
FOR APPLICANT TO FILL IN NEAREST Olive
CROSS ST
Fl
FIXTURE OR ITEM
O`er Lar Halveson
WATER CLOSET �L
ADDRESS
BATH TUB
CITY TEL NO
SHOWER
LAVATORY CONTRACTOR OPEN T]ROS, PLUMBING
SINS ADDRESS 525 N. Baldvain Ave.
DISHWASHER
CITY E1 Monte TEL NO GI-37644
CONTRACTORS STATE
LAUNDRY TUB REGISTRATION NO 197184 COUNTY ❑
l CLOTHES WASHER DRCT O GRO ZONE PR CESSED BY
1 WATER HEATER CCJJ
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD y
U
O
^� a
} N
11 0 $1 00 PER ITEM 11.00
OR FIXTURE $ APPROVALS D TE INSPEC OR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK ` 1-. .
TOTAL,FEE 13,00 ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I�HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AHD/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTTII��AL/RROPERTY UTILITY CO NOTIFIED
SIGNATURE OF PERM TTEF U11 ���!Ji""- `-
FINAL
RIF OVALIDATION ROBERT A WOOD
Cx B 0 CASH SUPERVISING MECHANICAL ENG R
Li�1'0 7 9 9 b J_3,l ? 5 n
13 CO
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