HomeMy Public PortalAbout4831 BALDWIN AVE_Plumbing__ 78A887A (CE 817B) 4/77
APPLICATION FOR PLUMBING PERMIT
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BUILDING A SAFETY DIVISI
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS 4831 N BALDWIN �—;—
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY TE PLE CITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER MODUMM GRI N, EARL
LAVATORY MAIL SAME
ADDRESS
SINK CITY TEMPLE CITY TEL NO 448-4057
DISHWASHER CONTRACTOR TRANE HCC
CLOTHES WASHER ADDRESS 2034 N PECK RD
SWIMMING POOL RECEPTOR
CITY SO EL MONTE TEL NO 579-7982
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO 265094 CLASS C-20
1 GAS SYSTEM 1 OUTLETS 3 00 DISTRICT NO �UP NE PR ESSED
OX 1
3 PX
OUTLETS OVER —I V
S PER SYSTEM INDUSTRIAL
WASTE APPROVAL
CD
INSPECTION RECORD
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W
d
N
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Plan check fee
PLUMBING PERMIT ISSUING FEE$ 7 00
TOTAL FEE 10 00
Plan check applicant
APPROVALS DATE INSPECTOR S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING \
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL v �,
PROPERTY UTILITYCO NOTIFIED
SIGNATURE
OF PERMITTEE 11••//��������� FINAL
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PLAN CHECK VALIDATION U.4Sm4,CT1CcAsHI PERM WVALIDATION cK `Mo CASH
0 5v- 1.3 5 D 1 000
POU ',OLDER
76A667 CE0817 12 64
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
ADDRESS U L
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY TES r`� C 1- V
FOR APPLICANT TO FILL IN NEAREST r
CROSS ST fc d W F.R "c-,) 4
NUMBER FIXTURE OR ITEM EACH FEE
OWNER �j (� O tj
WATER CLOSET SI 25 �y 1
BATH TUB 125 ADDRESS O f (3 A s-D w 1 ti Rue
SHOWER 125 CITY fA,P r,,rt:. 1 T Y TEL NO 4q S V
LAVATORY 125
CONTRACTOR t�FIC°I F C =NST P Lt-C
SINK 1 25 ADDRESS I C+9 2_0G' RQhI p V(�
DISHWASHER 125 CITY_P9_' rkpLZ CITY TEL NOI9Z`�(�7 V
LAUNDRY TUB 125 REGIS RAi ON NO '?-I Iw9 COiUNTY ❑
CLOTHES WASHER 1 25 DISTRICT NO GROUPE ESSED BY
WATER HEATER 1 50 - 41t
GAS SYSTEM _OUTLETS 150 WASTE RAPPPROVAL �
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD
V
O
F-
v
W
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N
Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING i224J
I HEREBY ACKNOWLEDGE THAT 1 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO GAS TEST
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE-0-3CJ V FINAL
DATION ROBERT A WOOD
cK M o CASH SUPERVISING MECHANICAL ENG R
LALO 8 2 0 5I� LEC 2 1 5 0 3.50-
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