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150(CE911)DPW 3187 COUNTY OF LOS ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING AND SAFETY DIVISION
FEE RECEIPT
WHEN VALIDATED THIS IS A RECEIPT FOR THE AMOUNT OF FEE COLLECTED AS SHOWN IN SPACE BELOW THE
SERIAL NUMBER DATE AND AMOUNT VALIDATED HEREON HAS ALSO BEEN VALIDATED ON YOUR APPLICA
TION OR OTHER DOCUMENT AND HAS BECOME A PART OF THE RECORDS OF THE COUNTY OF LOS ANGELES
FROM WHICH THIS RECEIPT MAY BE IDENTIFIED
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[-]PLAN CHECKING VALUATION $ ❑ WITNESS FEE& MILEAGE
STORIES CLASS ❑GRADING CASH BOND
❑GRADING PLAN CHECKING VOLUME CU YDS ❑ TRAILER APPLICATION
❑ELECTRICAL PLAN CHECKING ❑ E I R FEES
❑PLUMBING PLAN CHECKING ❑ REHEARING FEE
❑MECHANICAL PLAN CHECKING
❑ ENERGY PLAN CHECK ❑
❑RELOCATION APPLICATION
ED SPECIAL INSPECTOR COUNTY OF LOS ANGELES
N I ❑ JOURNEYMAN VUMBER EXAMIN TION DEPARTMENT OF PUBLIC WORKS
BUILDING & SAFETY DIVISION
125 S BALDWIN AVENUE
ARCADIA, CALIFORNIA 91006
(818)574 0941 c
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JOB ADDRESS 134 VLZLA-
NOTICE �® G*
APPLICATIONS FOR BUILDING d GRADING
PLAN CHECKING ISSUED UNDER THE PRO VALIDATION
VISIONS OF SECTION 303(C) LOS ANGELES
COUNTY BUILDING CODE WILL EXPIRE IF NO CASH CHK M
PERMIT IS ISSUED WITHIN 180 DAYS
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DIST NO gi�
Lr) i COUNTY OF LOS AN ELE?/ _
DEPARTMENT OF PUBLIC WORKS
I` BUILDING & SAFETY DIVISION
00 125 S BALDWIN AVENUE
RECEIVED BY ARCADIA CALIFORNIA 91006
(818) 574 0941
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