HomeMy Public PortalAbout5628 BALDWIN AVE_Plumbing__ (2) 76A667 17 8-60 Kb APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING����'
' COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUPZONE PERMIT NO.
` $ I /?a/ - y
BOULEVARD PLUMBING CO. RECEIVED BY READY FOR
PLUMBER VALLEY B DATE ISSUED
FIRST INSPECTION
BUILDADDRESS 8300 EAST VALLEY BLVD.
NG
CITY ROSEMEAD TEL. NO. AT. 2=271/9 ADDRESS . �
COUNTY 93M 6-30--5'/ LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CRoss ST. Chis.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) @ 0.50 S O d ADDRESS
BATH TUB Q 0.50 GIT /)1r/.[JI&ZL. NO S
SHOWER 0.50v
1 HEREBY A NOWLEDGE THAT ( HAVE READ THIS
LAVATORY (WASH BASIN) (� 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK ® 0.50 A 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 V ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIA P TY PERESCRIBED ABOVE.
GAS SYSTEM OUTLETS O.SO D SIGNATURE OF �1
WATER HEATER 0 0.50 PERMITTEE
SLOP SINK @ 0.50
INSPECTION RECORD
FLOOR SINK Q 0.50
FLOOR DRAIN ® O.50
DISHWASHER @ 0.501
DRINKING FOUNTAIN ® 0.501
URINAL @ 0.501 J
HOUSE SEWER @ 0.50 Q
Z
MISCELLANEOUS (�
O
1
APPROVALS
1 DATE INSPECTOR'S NAME
ROUGH PLUMBIN -AlAS PIPING i�/.�r�/.�' /A
GAS VENT iy rFf
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER )Q
PERMIT 1.00 GAS TEST
TOTAL FEE S l l� UTILITY CO. NOTIFIED
FINAL -• Yr
7BA667 (CE-817)-4/72 `. ��V ( ✓
APPLICATIO R PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING ''—
ADDRESS ,
HARVEY T. BRANDT, COUNTY ENGINEER 2
.LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
WATER CLOSET 1,75 OWNER :5
MAIL P4 ^
BATH TUB 1.75 ADDRES 2 6 IVQ I
SHOWER 1,75 CIT�Y.A—�Je y' . TEL. NO
LAVATORY 1.75 CONTRACTOR ( '
SINK 1.75 ADDRESS �+
i
DISHWASHER 1.75 •• CI ° TEL. N
CLOTHES WASHER 1.75 STATE LIC /r
LICENSE NO. CLASS aO
SWIMMING POOL RECEPTOR 1.75
DI$LR�ICT NO. UP NE E
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1.75 IN p.
WASTE APPROVAL G
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD C;p
OUTLETS OVER 30 09
5 PER SYSTEM
W
6.
H
' Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK '7�.Prn�-t�.J
Name ROUGH PLUMBING ; -7 /
Address I GAS PIPING 2fil 19/.`2-
City Tel. NO. GAS VENT
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 1,2 -7/
IAW
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PR ER Y REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS RECIUI RED BY LOS AN LES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LE L O NER OF, AND INTEND TO
RESIDE IN THE ABOVE DES IBED R ID TIAL PROPERTY. FINAL .,
In
SIGNATU RE
OF PERMITTE r.
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK V/LATION CK. CASH
//•
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9 4 N JUL 11 5 D 8.2 5 ,&a8