HomeMy Public PortalAbout5439 BALDWIN AVE_Plumbing__ 7UW7CEZ7M9' Job # 588 County Office TempleCi.ty
APPLICATION FOR PLUMBING PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
CASSAN AD GRBIFFIN s P of mor ADDRESS 5439 Baldw1n Av..
LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST 011 v e
NUMBER FIXTURE OR ITEM
# OWNER
`J, WATER CLOSET MAIL
1 BATH TUB ADDRESS
CITY TEL NO
SHOWER
2 LAVATORY CONTRACT�NTANA PLUMBING CONTRACTORS
I
SINS ADDRESS 13329 E C:-o Street
DISHWASHER CITY City of Mustry fi Mio ED 7 7226
CONTRACTOR S #96496 STATE ❑
LAUNDRY TUB REGISTRATION NO COUNTY
1
1 CLOTHES D CCT NO GROUP VV\ PR D BYWATHF4
GAS SYSTEM INDUSTRIAL
.Y/)
WASTE APPROVAL
INSPECTION RECORD
9 OR FIXTUR1 00 PER E $ 9.00
APPROVALS DATE �INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK /9
TOTAL FEE 1 00 ROUGH PLUMBING a
.51C.0,
GAS PIPING
AHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �...,�
CALIFORNIA OR THAT 1 M THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL OPERTY UTILITY CO NOTIFIED
•
SIGNATURE i-i !i
OF PERMITTE FINAL J�
®P VALIDATION ROBERT A WOOD
cK I m 0 CASH SUPERVISING MECHANICAL ENG R
l AC,0 9 4 710 1 iAt 18 5 A 11 0 0 M