HomeMy Public PortalAbout4820 BALDWIN AVE_Plumbing__ 76A887C (CE-81713) -9/75
• APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
S 4 0 N. Baldwin Ave.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET /_ oO LOCALITY Temple Cit
/ BATH TUB u� NEAREST ✓Jam��� � ����
CROSS ST
/ SHOWER OWNER Dick Bowen
LAVATORY MAIL
ADDRESS 1620 meianie Km Lane
SINK 0 CITY Arcadia TEL NO 445-1197
DISHWASHER 06 CONTRACTOR Owen Bros. Plumbing
CLOTHES WASHER
ADDRESS 11265 N, Baldwin Ave. ,
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CITY El Monte TEL NO "3-007$
STATE WATER HEATER i1 L CENSE NO 231 741 CI ASS C36-20 �
CJ CD
DISTRICT NO GROUP FNE[,( PRq5tSSED
BYGAS SYSTEM OUTLETS LI �, , _��„� OOUTLETS OVERI-
5 PER SYSTEM INDUSTRIAL 2
WASTE APPROVAL 0-
INSPECTION
INSPECTION RECORD Z
8 Wig S: - 74 �.r/Ly 4K —Q
Plan check fee
PLUMBING PERMIT ISSUING FEE $ 8
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPEC,TA 5 SIGNATURE
UNDER SLAB WORK -/
Address ROUGH PLUMBING 3- /
City Tel No 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 HOT WATER HEATER
PLUMBING
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LO
5 ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO -
RESIDE IN THE ABOVE D RIB RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATU RE �7
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
O [5 rrtr) t.J J U
a ,