HomeMy Public PortalAbout5140 BALDWIN AVE_Plumbing__ 76A667 CE#817 5 61
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUoILDING�AND SAFETY DOUNTYNIVISIEN
ON BUI DB ESS GS-/ d
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN T
CROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL NO
SHOWER
LAVATORY CONTRACTOR
SINS ADDRESS
DISHWASHER CITY 1EL NO S0�
LAUNDRY TUB REGISTRATICONTRACTON Nd "����Q S��C> CO A
CLOTHES WASHER DISTRICT NO GROUP ZONE PR S D B
WATER HEATER
GAS SYSTEM INDUSTRIAL O
WASTE APPROVAL V
v INSPECTION RECORD Im
O
U
W
a
z
® IIRE ITEM I /
O $ APPROVALS DATE INSPECTOR B SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
H 1 3 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GA$ TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROP TY UTILITY CO NOTIFIED
SIGNATURE t o `--y';/
OF PERMITTE FINAL
VALIDATION ROBERT A WOOD
EK M o CASH SUPERVISING MECHANICAL ENG R
�_ LACoo 9 7 IQ; M29 5 0 3.50-