HomeMy Public PortalAbout4849 BALDWIN AVE_Plumbing__ 76A667 CE817 8 58
AYo APPLICATION
ATION FOR PLUMBING PERMIT
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE County Engineer ADDRESS
CASSATT D GRIFFIN Sup t of Building LOCALITY G i
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM CROSS ST
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL NO
LAVATORY t CONTRACTyj
SINS L ADDRESS� _��
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DISHWASHER CTPY TEL NO
CONTRACTOR S STATE
LAUNDRY TUB REGISTRATION NO OTCOUNTY
/ CLOTHES WASHER L [WATE
GRP ZONE R ES Y
WATER HEATER
GAS SYSTEM
OVAL
INSPECTION RECORD
'7''�iA
APPROVALS
@ O 00 PER ITEM *ry
OR FIXTURE $ / DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK — 7.� --�—
PERMIT $ 2100 ROUGH PLUMBING / -2.,
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER I ti
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES 1
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY
to-
SIGNATURE
OF PERMITTEE O� FINAL
ROBERT A WOOD
®F VALIDATION SUPERVISING MECHANICAL ENG R
EI 0 CASH
IACO2 9-4 3 -u; SEP ?1 5 A 900 `°
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