HomeMy Public PortalAbout5223 BALDWIN AVE_Plumbing__ 76A667 CE0817 6 65 U (�
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'APPLICATION FOR PLUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS �- 7_3
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY les �„ P LE C ,7
FOR APPLICANT TO FILL IN NEARCROSS SST w ZU
NUMBER FIXTURE OR ITEM EACH FEE
OWNER �
WATER CLOSET it 25
:HOWER
ATH TUB 125 ADDRESS 125 CITY �� ( � TEL NO
LAVATORY 125 CONTRACTOR I
SINK 125 ADDRESS \Q)z �,O 1A
DISHWASHER 1 25 CITY Tv�kpr�,U �, TEL NOSTATE LIC
LAUNDRY TUB 1 25 LICENSE NO -,1 JS39 CLASS 'N7
CLOTHES WASHER 125 DISTRICT NO GR ZONE P 5
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WATER HEATER 1 50 ��
GAS SYSTEM OUTLETS 150 INDUSTRIAL O
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 / NSPECTION CORD U
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I APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR, PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE O GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND T
RESIDE IN THE ABOVE DESCRIBED Rf.SIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE l`
OF PERMITTEE
FINAL
V LIDATION
CK M O CASH
L_' WR MfR2 ! Y _ 3.50
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