HomeMy Public PortalAbout5622 BALDWIN AVE_Plumbing__ (2) '8"867 17 8-50"13 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES .
WILLIAM J. FOX', CHIEF ENGINEER PLUMBING 1
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
1
PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED
1"^ FIRST INSPECTION
ADDRESS 8300 EAST VALLEY BLVD. f, y �5'/
ROSEMEAD AT. - S BUILDING ` �►/�
CITY Mn TEL. .N ADDRESS �J
COUNTY' 93,y, S/ LOCALITY
LICENSE NO. EXPIRES O
NEAREST
PERMIT FEES CROSS:ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) @ 0.50 S O O ADDRESS. 3 Y
4AK)BATH TUB @ 0.50 TEL. NSHOWER @ 0.5U 0 1 HEREBY KNOWLEDGE THAT i HAVE
LAVATORY (WASH BASIN) 0.50 APPLICATION AN STATE THAT THE ABOVE`I8 CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 0 STATE LAWS 'REGULATING PLUMBING.
I. .CERTIFY. THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB R.TRAY @ 0.50 -5-90ANGELESCOUNTY LICENSE. OR I AM THE LEGAL OWNER
OF THE RESIDENTIA PERTY DESCRIBED ABOVE.
GAS'SYSTEM OUTLETS ® 0.50 a SIGNATURE OF d
WATER HEATER @ 0:50
SLOPSINK a 0.50 INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50. I
HOUSESEWER @ 0.50 Q
Z
MISCELLANEOUS (7
E
0
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT rJf
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK': SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT t.00 GAS TEST
TOTAL FEE
'} UTILITY CO. NOTIFIED �....�
$ 6I�CJ
FINAL
78A867-CE#817 4-64
APPLICATION FOR PLUMSIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ` s
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS , 'JGL �LLLL'
WILLIAM A.JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO.FILL IN NEAREST
CROSS ST. /Ji
NUMBER FIXTURE OR ITEM EACH FEE / '✓
OWNER
WATER CLOSET $1.25 4MAIL
BATH TUB 1.25 ADDRESS , �(4
SHOWER 1.25 CITY,,, (T. e TEL. NO.
LAVATORY 1.25 CONTRACTOR
r SINS 1.25 ADDRESS
DISHWASHER 1.25 CITYL'L %J TEL. NO.
LAUNDRY TUB 1.25 REGISTRATION NO. �7 f�Yf CSTATE (]
STATE
❑
CLOTHES WASHER 1.25 ��� DISTRICT NNO.g GROUP NE BIR FD BY
WATER HEATER 1.50 1:5-1 ((�J�(( 4-- (/�
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL �-
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
ix
O
H
Luto
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 5 2 00 UNDER SLAB WORK
TOTAL FEE
`6 .` �y ROUGH PLUMBING
.7/J GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. /1 UTILITY CO. NOTIFIED
SIGNATURE 02 a
OF PERMITTEE - 1 t 1 t.t . Gam' FINAL Z
�LIDATION ROBERT A. WOOD
cK. M.o. cases SUPERVISING MECHANICAL ENG'R
� � 6 7 6 S.- All 17 5 D 3_50-