HomeMy Public PortalAbout4938 BALDWIN AVE_Plumbing__ 76A667 CE#817 6 65
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER t�
BUILDING AND SAFETY DIVISION BUILDING / ��
JOHN A LAMBIE COUNTY ENGINEER ADDRESS I
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY I
FOR APPLICANT TO FILL INNEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1 25 MAIL
BATH TUB 1 25 / ADDRESS
f SHOWER 125 I CITY TEL NO
,y1 LAVATORY 125L,� CONTRACTOR
I SINN 125 i a ADDRESS
DISHWASHER 1 25 '�s' CITY �J TEL NO 9�3STATE
LIC
LAUNDRY TUB 1 25 ^^ LICENSE NO X3 / / CLASS C-3
CLOTHES WASHER 1 250� DISTRICT NO GROUP ZO PRO SSED BY
WATER HEATER 1 50 L) � Q 1
GAS SYSTEM -S OUTLETS 150 5p INDUSTRIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD U
ad
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V
Lu
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Z
APPROVALS DATE INSPE OR S SIGNATURE
PERMIT S 2 00 UNDER SLAB WOpRtK L! y
ROUGH PLUMB NG
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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING f
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ted►
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE AB DE IBED RESIDENT L PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
14 VALIDATION
M O CASH
LAL o 1 3 9 ?\So OR 19 5 D 1 6.2 5