HomeMy Public PortalAbout5024 FARAGO AVE_Plumbing__ 76A607 CE817 113r 60
APPLICATION FOR PLUMBING PERMIT �
COUN'T'Y OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION RUUDrrs' Q V
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEST
CROSS ST
NUMBER FIXTURE OR ITEM
OWNER
Z WATER CLOSET MAM
h I BATH TUR ADDRESS
CITY TEL NO
SHOWER
Z LAVATORY CONTRACTOR �1 , ! / /J
ADDRESS
SINK 7 A� %//�eeo G/ A-f
DISHWASHERCITY 3Qld6v1 N TEL NO
LAUNDRY TUB REGISTRATION NO 2-795-6 COUNTY
CLOTHES WASHER DISTRICT NO GROUPZONE P CESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD////
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O00 PER ram
R FIXTURE $ I 1173^
APPROVALS AII��TE INSPECT6R 8 1 ATURE
PERMIT $ 2 00 UNDER SLAB WORK 4 944
TOTAL FEE I !- ROUGH PLUMBING
J GAS PIPING r r✓�
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT if
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE L
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED //y6;z
SIGNATURE
OF PERMITTE zzLl�ee2
FINAL /ai/�LZ �1
VALIDATION ROBERT A wood
cK M O CASH SUPERVISING MECHANICAL ENG R
a .ACO 1. 9 2 8% Ja 2 0 5D 1 3.7 5 N a
76A667 (CE 817) 4/72 �
APPLIC 10( FOR UMBINC ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDING
ADDRESS
HARVEY T BRANDT COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1 75 OWNER
MAIL
BATH TUB 1 75 ADDRESS,
SHOWER 1 75 CITY G TEL NO
LAVATORY 1 75 CONTRACTOR
SINK 1 75 ADDRESS
DISHWASHER 1 75 CITY TEL NO
CLOTHES WASHER 1 75 STATE L LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 75 All
DISTRICT NO GROUP ZONE CESS BY
LAWN SPRINKLER SYSTEM 1 75
WATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 75 INSPECTION RECOR V
OUTLETS OVER
5 PER SYSTEM 30 7 TC CD
F--
U
rA
2C
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 1 191
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING J�
PLUMBING GAS TEST _
[ HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF 7
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED REST :;IAL P OPER TY FINAL
SiGNA TU RE
OF PERMITTE I
PERMIT VALIDATION 0C. M O CASH
PLAN CHECK VALIDATION CK M 0 CASH
U'- 0 6 5 815, j PR 18 5 D ,J 4 75A
M U 'u