HomeMy Public PortalAbout5612 BALDWIN AVE_Plumbing__ ]6A687 (CE-8.f7•) - 1175'
AP.PLICATIO-N FOR,"P;LUMB:IPER
I
" COUNTY OF LOS ANGELES ' 'DEPARTMENT-OF COUNTY ENGINEER; ;
BUILDINQ-AAND SAFETY DIVISION-
1NA'1 E CHECKS PAYABLE TO:• BU;ILD.ING
ADDRESS
HARVEIP T. BRANDT, COUNTY ENGINEER:
LOCALITY
/pL.� •'
FOR A'PPLIC.ANT.TO,F$LL IN(PRINT OR TYPE.1 NEAREST
CROSS ST. '
NUMBER` FIXTURE OR ITEM FEE
WATER CLOSET ' 2.00. OWNER
MIA 11
.,BATHTUB'' 2.00. ADDRESS. Y.. Es
-SHOWER "p`O 2.G6 /L �s3 7''�.�'
J CITY .TEL.N O.
LAVATORY• 2.00 CONTRACTOR s
S.INK' 2.00 ADDRESS iyj9' SA fI` F
DISHWASHER
}CITY'' TEL. N'O-. !jI
_ 7'F .y7,z
CLOTHES WASHER 2:OU ST4TN LI.C•.
LICE SENO,. pts' 7.9 CLASS..
4'
SWIMMING POIDEAEC.EPTOR2.00'
DISSS BV
LAWN SPRINKLER SYSTEM 2.00 �V 0
tCT IVO.[GROLIP1. 20NE „
v7
<Ci �7
WATER HEATER 2.00 IN TE '
S' APPROVAL-, ..
GAS SYSTEM OUTLETS . 2..00. I' '
OR
OUTLETS•OVER. „
�• ' �r`'f:NSPEC+TI'ON REC D, ` '• a
5
30 t }/� v
5 PER SYSTEM -r J
LLI:
,
Plen Check fee See'Re.verse.
PLUMB.I.:NG.PERMIT ISSUING FEE S'
' ' • , '' - , ' • `TOTAL FEE- -
Pla-6 check applicant.
APPROVALS DATE,. I.Ns PEeTD.Ws siGNATURE.
UNDER SLAB WORK 1,
Nartle RObIJHI:PL'LIMBING
: .. c.�
"Addres•s, GAS PIPING
City. Tel. No. GAS'VENT I7 i. R �t�•�•/
HOT WATER'HEATER , I• "` Q,�'
I HEREBY.ACKNOWLEDGE THAT'1:,'HA•VE'R.EAD•.TNIS APPLICATION. � _ - •�� -'•�`' ''• � "'
AND STATE THAT THE ABOVE IS 'CORRECT'.AND AGREE TO.COMPLY PLUMBING FIXTURES ' �'•A fi :r<
WITH 'ALL COUNTY- ORDINANCES'AND' STATE LAWS REGULATING- - Y
PLU.MMAG. - -----
GA TEST '�' 1�•` x!'". •�•�"' w
1 HEREBY CERTIFY.. THAT I AAA PROPERLY -REGISTERED AND/OR UTILITY CO. NOTIFIED '�) � f �• - -,
LICENSED' AS REQUIRED BY' ,LOS. ANGELES' COUNTY AN TATE OF,
CAL:FORNIA -OR,THAT CAM, THE LEGAL OWNER O�F, A TEND
RE91 DE''IN TFiE ABOVE.DESC..RISED'RESIDEN_TIAL PAOP FINAL '
l'
SI•GNATU RE .;.
OF PE•RNIITTEE
PERMIT VALIDATION
.. CKA .O. CA'BN
PLAN-CH VALIDATION, _ CK. M,o.. -CASH
T
7BlGW f7 °•OO 10 APPLI{„ATION FOR PERMIT
DEPARTMENT'OF BUILDING AND SAFETY PLUMBING
����'
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN
DISTRICT NO. GROUP I ZONE PERMIT NO.
VALLEY BOULEVARD P -3-1 .4- 1 1. PLUMBER RECEIVED BY READY FOR DATE ISSUED
ADDRESS
5300 EAST VALLEY BLVD. FIRST INSPECTION
ROSEMEAD BUILDING
CITY A IE�I TEL. NO. A
COUNTY 93M I.:f. LOCALITY
LICENSE NO. EXPIRES
NEAREST /01
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNERjj+Lr•C{�
,�/ MAIL
WATER CLOSET (TOILET) @ 0.50 ffi 6 ADDRESS
I, r
BATH TUB @ 0.50 0 OI � EL. NO/20-/
^� SHOWER @ 0.50 S0 1 HEREBY KNOWLEDGE THAT I HAVE READ THIS
!� LAVATORY (WASH BASIN) @ 0.50 I IJ APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ 0.50 r� 1 CERTIFY THAT I POSSESS THE ABOVE VALID I.OS
LAUNDRY TUB OR TRAY @ 0.50 ,rj�� ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIA�///P/'gOPERRTTYY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 —O SIGNATURE OF /S
WATER HEATER @ 0.50 PERMITTEF
SLOP SINK @ 0.50 I INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50 /'� aM�it/' � �d� �+•
DRINKING FOUNTAIN
@ 0.50 _(�1 !✓!>�✓r e.ol.�/l,.t✓T�'J�glTa-®.M ,•i•'
URINAL @ 0.301
HOUSE SEWER @ O.SO I Q
Z
MISCELLANEOUS (�
R'
O
I
I
I
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBIN P,
GAS PIPING
GAS VENT 7sIX
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 1 SEWER cl
PERMIT . I 1.00 GAS TEST 1 I —z,
UTILITY CO. NOTIFIED
TOTAL FEE I ffi �Q 0 FINALS