HomeMy Public PortalAbout4923 BALDWIN AVE_Plumbing__ 76A667 CE817 1157 t
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ABUILDING
DDRESS
JOHN A LAMBIE County En meer
C BATT D GRIFFIN Sup t of Building LOCALITY
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FOR APPLICANT TO FILL IN NEAREST S3T
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NUMBER FIXTURE OR ITEM C
WATER CLOSET OWNER G Q
BATH TUB ADDRESS k [,
t CITY L TEL NO
SHOWER r
LAVATORY CONTRACTOR Valley Plumbing Co
/ SINIK ADDRESS 442 w Fleetwood P1
DISHWASHER CITY Glendora TEL NO Ed 5-12 -Sz,
LAUNDRY TUB REGISTRAT ON NO 160847 CONTRACTOR S STATE ❑
COUNTY ❑
CLOTHES WASHER
DIST 40 GROUP WNE/ READY FOR INSPECTION
WATER HEATERLf
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD-——A
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%,
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APPROVALS
@1 $100 PER ITEM DAT INSPE OR SA�IGNATURE
(/ OR FDITURE S UNDER 82'ffiWORK
PERMIT $ 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
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
SIGNATURE
OFPERMITPE FINAL
ROBERTA WOOD
®r SUPERVISING MECHANICAL ENG R
t7ATION
O CASH
2 1,9-8 3% FES 4. 5 A
1200 M
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