HomeMy Public PortalAbout5307 BALDWIN AVE_Plumbing__ 6
DBSI7' APPLICATION FOR PLUMBING PERMIT
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DBS IVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING
/ A k
JOHN A LAMBIE COUNTY ENGINEER ADDRESS / !
CASSATT D GRIFFIN SUP T OF BUILDING /D �lLOCALITY b IT)l
FOR APPLICANT TO FILL IN I NEAREST
,A, CROSS ST I( (.,
OWNER (' ry/� 1 �� £VI � DISTRICT O GROUP WREADY FOR INSPECTION
MAIL 3 5A r / _/) I e
INDUSTRIAL
ADDRESS }} j�/ �I `7' I !/ 7� V �}
CITY7)FP 1 4& 1, �7 TEL NO WAS E APPROVAL
PLUMBER p� ry INSPECTION RECORD
ADDRESS G\
CITY TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE ,d
WATER CLOSET (TOILET) @ $100 $
BATH TUB @ $100
SHOWER @ $1 00 v W
LAVATORY (WASH BASIN) @ $1 00
KITCHEN SINK @ $100
�i V
DISHWASHER @ $100 IUJI
LAUNDRY TUB OR TRAY @ $100 �+
CLOTHES WASHER @ $1 00 Aldle
WATER HEATER @ $1 00
GAS SYSTEM @ $1 00
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE .2-Qd GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 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 I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIALPROPERTY
SIGNATURE
OF PERMITTEE �+"� f+�'�1 FINAL _rv�
OHN A LAMBIE COUNTY ENGINEER VALIDATIO ROBERT A WOOD CHIEF PLBG INSPECTOR
CK M O f CAS
ljf,o 4 e �8 APR 10 3 200 In
a
76A667A '
CEY°$71RLV x/781
®3 e
APPLICATIO OR PL B ING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ��O
ADDRESS
NUMBER FIXTURE OR ITEM @ FEE
3
WATER CLOSET LOCALITYNEAREST
r BATHTUB 3 CROSSST Q�U
SHOWER OWNER
LAVATORY ? MAIL
J ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
�l
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY � e TEL NO
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO 2 w CLASS 3 b
/ GAS SYSTEM OUTLETS APPROVALS DATE INSPE OR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK r
S PER SYSTEM ROUGH PLUMBING / 4
GAS PIPING ®<
GAS VENT
HOT WATER HEATER 0p�
PLUMBING FIXTURES (9
GAS TEST ;W r 66EE�11
Plan check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATION
Name
Address ofd, Co^117
City Tel No ��d� (� if'���d s P2n,l eq �L
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE a�
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES V
AND STATE LAWS REGULATING PLUMBING P RMIT VALIDATIONtn (,+, f�� y��.t ..14 9 17 A
I HEREBY CERTIFY THAT I AM PROPERLY RE ED AND/OR LICENSED AS A/19 �Npe- qu l7°1-�i{IAtGive
REQUIRED BY LOS ANGELE COUNT ND STATE OF I IA OR THAT I AM THE 'I # O O'o O O 5
LEGAL OWNER OF AND I ND T R SIDE IN THE ABOV ES BED R IDENTIAL
PROPERTY 2 Q Q 1 9 0 0
SIGNATURE
OF PERMITTEE 00019005
DIST OOCESSE BY 0 6 1 41-79
i U
INDUSTRIAL
WASTE APPROVAL