HomeMy Public PortalAbout5204 BALDWIN AVE_Plumbing__ ® e
76A 67
Das APPLICATION FOR PLUMBING PERMIT
171DIVISION OF BUILDING AND SAFETY
' Department of County Engmeer
County of Los Angeles BUILDING L . P
IV
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY pI�
FOR APPLICANT TO FILL IN I CROSSSST -B /� ZLI S r7n W
OWNER j I -T-0 f? L= DISTRICT NO GROUP ZONE I READY FOR INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY TEL , V NO WASTE APPROVAL
PLUMBER J , A, OR - i6- INSPECTION RECORD
ADDRESS 14 1 /L (G-'l-D vr:-
CITY /?C 1 {i TEL NO /If J,2,&O
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM /FEE
WATER CLOSET (TOILET) @ $1 00 /
BATH TUB @ $100
SHOWER @ $100
1 LAVATORY (WASH BASIN) @ $1 00 67
KITCHEN SINK @ $1 00
r DISHWASHER @ $1 00
1 LAUNDRY TUB OR TRAY @ $100
J CLOTHES WASHER @ $1 00
/ WATER HEATER @ $100 I
GAS SYSTEM @ $100 1
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK / Iw
PERMIT $ 1 00 ROUGH PLUMBING �f! �jJ 11Jrf/ ��j
V co GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ HIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST v
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF i
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL P 0PERTY
SIGNATURE
OF PERMITTEE FINAL
a
JOHN A LAMBIE COU Y ENGINEER �C$LIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CR M 0 GSH
ACO 367", fIAR21 3 80Q '�