HomeMy Public PortalAbout5031 FARAGO AVE_Plumbing__ 76A667 CE817 12159 TEMPLE CiTV
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY IVISION BUILDING
JOHN A LAMBIE COUNTY NGINEER ADDRESS O /q `
v
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY e--
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM OWNER /v A
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL NO
SHOWER
CONTRACTOR
LAVATORY (/t!/¢R/Q��►� L-
SINK ADDRESS �0 �,! ���/af/14 PG
DISHWASHER CITY eQ / w/&- TEL NO
CONTRACTORS {�/ Sl
LAUNDRY TUB REGISTRATION NO O COUNTY El
CLOTHES WASHER DIST��NIO� G� ZONE PR CESS f BY
WATER HEATER V
GAS SYSTEM INDUSTRIAL.
WASTE APPROVAL
INSPECTION RECORD y
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f PER ITEM
Of F ITTURE $ I l
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEEH � ROUGH PLUMBIN
GAS PIPING & d ra•
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT 1i
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
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 GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED REBID IAL PROPERTY„ UTILITY CO NOTIFIED
SIGNATUREpZ.yf—
OF PERM ITT FINAL
®r VALIDATIO ROBERT A WOOD
CQ m 0 QASHl
SUPERVISING MECHANICAL ENG R
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76A57 CE817 12/59 /`�
APPLICATION FOR PLUM ING PERMI �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDINGS1FETYIVISION BUILDING cj
JOHN A L M IE OUNTY hNGINEER ADDRESS
WILLIAM A JENSEN SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL NO
SHOWER
J' LAVATORY CONTRACTO
SINK ADDRESS ��
DISHWASHER CI TEL NO
CONTRAC ORS '/ STATE
LAUNDRY TUB REGISTRATION NO �-�� O/� a��/ COUNTY ❑
CLOTHES WASHER DISTRICT NO GRP Z NE � �Y
WATER HEATER (f/� lf/
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
a
(e. i 9'� "rte O
U
/ w
w
w
$1 DOPER ITEM V �sfd.� d kL1°3.
OR FIXTURE $ APPROVALS PATE INSPECTOR S SIGNA URE
PERMIT $ Q Ov V UNDER SLAB WORK
TOTAL FEE 9*�C4a�YYf f
ROUGH PLUMBING
GAS PIPING
1HEREBY 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
PLUMBING HOT WATER HEATER w
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
CE
LINSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDEN�A PRRWf� UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE
FINAL
®r VALIDATION ROBERT A WOOD
cK m O cASR SUPERVISING MECHANICAL ENG R
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