HomeMy Public PortalAbout4920 BALDWIN AVE_Plumbing__ 76A607-CE817 10 60 �
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APPLICATION FORZ
MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS T
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET
MAIL
I BATH TUB ADDRESS
cTTY TEL NO
SHOWER
LAVATORY cONTRACTORAlert Plbg & Htg.
snls
ADDRESS 13933 So. Crenshaw Blvd.
DISHWASHER CITY Hawthorne TEL NO OS 9-3691
ATE
LAUNDRY T" REGISTRATIO t N019 3 617 C-36 CO TUNNTY 51
f CLOTHES WASHER DI RIOT NOGROU ZONE PR S8ED BY
WATER HEATER �
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL }
INSPECTION CORD D'
11014-3 Zell �� o
0
Qp $100 PER ITEM I t
OR FIXTURE $ 7 v0 APPROVALS DATE INSPECTOR S SI 9NATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE �� ROUGH PLUMBING '
GAS PIPING- �.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT !) �gf_,yQ�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMHOT WATER HEATER ''4 ;I 1 !/ "`JlU%
BING f! ,,i/✓
1 HEREBY CERTIFY THAT 1 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 THE ABOVE GAS TEST
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO-NOTIFIED
SIGNATUREr I ✓l
OF PERMITTE FINAL #;T� .n
C1JALIDATION ROBERT AI WOOD
cK M o CASH SUPERVISING MECHANICAL ENG R
Li 6326 o QCT 4 5 D c� � C) r