HomeMy Public PortalAbout4834 BALDWIN AVE_Plumbing__ L
.76A667 - CE817 5/70
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING /) l
JOHN A LAMBIE COUNTY ENGINEER ADDRESS /J
COLEMAN W JENKINS
SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST U
NUMBER FIXTURE OR ITEM EACH FEE
OWNER e
WATER CLOSET 1 50 O
MAIL
BATH TUB 1 50 ADDRESS
SHOWER 1 50 y CITY TEL NO
1 12 LAVATORY1 50 S o CONTRACTORiff C�
SINK 1 507 ADDRESS sa /—
DISHWASHER1 50 CITY TEL NO 73
/
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO 7� CLASS (-�-
SWIMMING POOL RECEPTOR 1 50
DISTR'C� GR ZONE PR CESSED BY
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER 1 507SINDUSTRIAL
���
WASTE APPROVAL ^
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD �V{
CUTLETS OVER
5 PER SYSTEM 30 z
O
N
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE 8 00
TOTAL FEE
APPROVALS DATE I ECTOR SIGNATURE
Plan check applicant UNDER SLAB WORK 1
Name ROUGH PLUMBING ?�{�
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER _2
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING I
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AHD/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL HER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED 1 IAL PROPER FINAL %%TP
SIGNATURE JACK R ALLEN SU PERV1i)
C ANICAL ENG R
OF PERMITTEE
PERMIT VALIDATIO o CASH
PLAN CHECK VA TION CK M Of
CASH
L, -7 4 b aCT 28 0 2 2 2 5N CM