HomeMy Public PortalAbout5423 BALDWIN AVE_Plumbing__ 76A667-CE#'817 5-6I
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIMION BUILDING %
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS �! W >r'7
-7 WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY92 L�e
FOR APPLICANT TO FILL IN NEST
CROSS ST. a le
-
NUMBER FIXTURE OR ITEM T
OWNER ,
' WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL NO.
SHOWER
CONTRACTOR
LAVATORY
SINS ADDRESS
DISHWASHER CITY TEL. NO. 03 93§91
CONTRACTORSSTATE ❑
LAUNDRY TUB REGISTRATION NO. r y+� 7 -36 COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZflIdE P SED BY
WATER HEATERL ) - a
GAS SYSTEM INDUSTRIAL 0
If WASTE APPROVAL V
INSPECTION RECORD w
OFCL.
"2 IA
Z
$1.00 PER ITEM
OR FIXTURE ' APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING -
1 HAV
HEREBY ACKNOWLEDGE THAT 1 E READ THIS PLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER U r
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE GAS TEST ' /-
DESCRIBED RESIDENTIAL PR 7Y. UTILITY CO. NOTIFIED f
SIGNATURE r
OF PERMITTEklvm�_�
FINAL
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VALIDATION ROBERT A. WOOD
CK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
V i.l J. J_ ..