HomeMy Public PortalAbout5021 FARAGO AVE_Plumbing__ "A 7A �
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 5021XR Farago Ave
NUMBER FIXTURE OR ITEM ® FEE
LOCALITY Temple City
WATER CLOSET
BATH TUB
cCROSS ST Grand Ave
SHOWER E:V OWNER F Russo
LAVATORY ADDRESS 5021 Farago Ave pp
SINK _ 3 CITY Temple City TEL N0286-5861
DISHWASHER CONTRACTOR Universal Plumbin
CLOTHES WASHER � ADDRESS 2631 (lee Ave
SWIMMING POOL RECEPTOR
CITY SO El Monte TEL NO 575-3�'6
LAWN SPRINKLER SYSTEM TATE
WATER HEATER LICENSE NO 316o18 ASS C36&2o
GAS SYSTEM OUTLETS APPROVALS TE INS CTOR 5 SIGNATURE
OUTLETS OVER UNDER SLAB WORK a
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT w
HOT WATER HEATER O
PLUMBING FIXTURES
GAS TEST 15
Plan check fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATI N
Name
Address �� zp� 92--OW-3
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City Tel No `T ®0 1y7 ®+
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE A�
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES @494 A
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PR Y REGISTERED AND/OR LICENSED AS # Do O o a 5
REOU IRED BY LOS ANGELES COUNTY D TATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF AND INTEND TO E IN THE AB VE DESCRIBED RESIDENTIAL L q
O D 2 a o o
PROPERTY
SIGNATURE f G D 28005
OF PERM ITTEE 15-79
DISTRICT N d P CESSED
d v
INDUSTRIAL
WASTE APPROVAL
76A667 CE617"0
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APPLICATION OR PLLJMI3IN PERMIT
CO OF LOS ANGELES
DEPARTNIE OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION f7ADD! S6
JOHN A LAMBIE COUNTY ENGINEER ?t/ - 2WILLIAM A JENSEN SUPT OF BUILDINGFOR APPLICANT TO FILL IN ►+�1
NUMBER FIXTURE OR ITEM OWNER
/ WATER CLOSET NAM 2 G
BATH TUB
ADDRESS U/ /�`,� F2✓� U
CITY ? j1, /4�` �! TEL NO y
SHOWER
LAVATORY CONTRACTOR
ADDRESS /3 9 d3 . �'&&x;S'�j/rjia
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DISHWASHER CITY 9a, // a- TEL No 6 4yrl
CONTRACTOR S SLATE
LAUNDRY TUB REGISTRATION NO I lo/ COUNTY fffli
CLOTHES WASHER DISTRICT N�, GROU ZONE PR SEED BY
WATER HEATER �/ O
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
v
a
0 OR 0"Im.RErr.Em $ I r
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE90ROUGH PLUMBING
GAS PIPING w
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT l
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE L / i
OF PERMITTE FINAL 7���'/�i� � i%✓/'/i w�""
®r IV ATION ROBERT A WOOD
Cr e 0 CA88 SUPERVISING MECHANICAL ENG R
(AC,04945 A?R 5 5 0 900
76A667 CE817 12/59 tL1
APPLICATION FOR PLUMB G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTYENGINEER
BUILDINGBJOHNIA LAAMB ECTTY ENG NEOERr ADDRESS �G`��
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS BY
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET
MAIL
SATH TUB 9
SHOWER CITY TEC NO
LAVATORY CONTRACTOR
ADDRESS
SINK
DISHWASHER CITY TEL NO
CONTRACTORS STATE ❑
LAUNDRY TUB REGISTRATION NO COUNTY ❑
CLOTHES WASHER DISTRII NO GRO P ZONE PRO SD BY
WATER HEATER vel V Of/ All
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
7 / INSPECTION RECORD
v —d 0
U
a
/!i►..D i r �! ems. F
U
y
$100 PER ITEM I /
OR FIXTURE $ APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK /
TOTAL FEE T ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
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 PROPERTY UTILITY CO NOTIFIED
SIGNATURE / r
OF FERMI TTE FINAL if/;llle0 //-"-,f G rT
Or /1VALMATION ROBERT A WOOD
cs e o CASH SUPERVISING MECHANICAL ENG R
L11C0 5 D 6 4 ;::g "R 17 5 D 3 00 K
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