HomeMy Public PortalAbout4841 BALDWIN AVE_Plumbing__ 76A667 CEr817 6 65
APPLICATION FOR PLUMBINGPERMIT /
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION TADDRESS
LDING
JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS SUP T OF BUILDING ALITY
FOR APPLICANT TO FILL IN RESTSS ST i
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1 25 J Z^
MAIL
BATH TUB 125 ADDRESS
SHOWER 125 CITY LS, TEL NO
LAVATORY 125
Z� CONTRACTOR
SINK 125 ADDRESS
DISHWASHER 125 CITY TEL NO
STATE LI C
LAUNDRY TUB 1 25 Z- LICENSE NO CLASS
CLOTHES WASHER 1 25 DISTRICT NO GROUP E PRO ED BY-
WATER HEATER 150 0
GAS SYSTEM OUTLETS 150 0 INDUSTRIAL (om.
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM 30 V
� SPECTION RECORD
V
W
a
V)
Z
APPROVALS r DATE INSPECTOR S SIGNATURE
PERMIT 5 2 O UNDER SLAB WORK
- tinROUGH PLUMBING f
TOTAL FEE GAS PIPING
IH
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
PLU NHOT WATER HEATER A
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURE /
LICENSED AS REQUIREDBY LOS ANGELE Y AND S T OF
CALIFORNIA OR TH AM THE LEGAL WN F NO I TO GAS TEST q
RESIDE IN THE A VE ESCRIBED REST NT RTY UTILITY CO NOTIFIED
SIGNATURE
OF PERM l
FINAL
,-�LIDATION
CK M O CASH
LAU01 5 7 6:D APR 27 5 D r 8.50— 17
LAt 0 1 5 7 71 PPR 27 5 D 1.50-