HomeMy Public PortalAbout5013 BALDWIN AVE_Plumbing__ 76A6674 C E,V81 7 5/63
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING O `
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN Sup T OF BUILDING
LOCALITY
17FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $125 MAIL
BATH TUB 1 25 ADDRESS
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINK 125 ADDRESS
DISHWASHER 125 CITY TEL NO ��
CONTRACTOR 8 t7/ 1/ STATE
LAUNDRY TUB 125 REGISTRATION NO / 7 COUNTY ❑
CLOTHES WASHER 125 DISTRICT GROUP ZONE ROOESSED BY
WATER HEATER 1 50 J
r
GAS SYSTEM—4---OUTLETS— 1 50 INDUSTRIAL
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPPE-C-T,ION RECORD U
Ind
A
APPROVALS— ATEJ INSPEC R 5 SIGN T E
PERMIT $ 2 00 UNDER SLAB WORK
/ ROUGH PLUMBINGglq
Q
TOTAL FEE /V I� GAS PIPING bor
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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO `I
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE / r
FINAL
LATION ROBERT A WOOD
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CK M M o CASH SUPERVISING MECHANICAL ENG R
�I ti.o 5 7 4 6 FEB 2 0 5 D 1 6 2 5"