HomeMy Public PortalAbout5032 FARAGO AVE_Plumbing__ I
76 A 6#1_ C_417 7-69 �
1
APPLICATION FOR PLUMBING PE IT
• COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION d Z T� /�/'
~ JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEARSTTCROS
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1 50MAIL
BATH TUB 150 ADDRESS TO,3
SHOWER 1 50 CITY W TEL NO Z /
LAVATORY 1 50 CONTRACTOR
1 SINK 1 50 ADDRESS J/ 2 it d
DISHWASHER 1 50 CITY GZ TEL O 'Z7 A
CLOTHES WASHER 1 s0 STATE LIC
LICENSE NO �Q� `CLASS
SWIMMING POOL RECEPTOR 1 SO DISTRICT NO GROUP ZONE j P SSED BY
LAWN SPRINKLER SYSTEM 2 00 06 --.r
WATER HEATER 1 50 INDUSTRIAL Q
WASTE APPROVAL u
/ GAS SYSTEM OUTLETS 1 50 / �.Q INSPECTION RECORD Af z
OUTLETS OVER 30 O
5 PER SYSTEM
d
N
z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE $ 2 00
TOTAL FEE APPROVALS RATE 94PECTOR SIGNATURE
Plan check applicant UNDER SLAB WORK y2 1
Name ROUGH PLUMBING t 2-
Address
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT '/AM
THE tff��
RESIDE IN THE ABOVE CRIMEFINAL --
SIGNATURE JACK R ALLEN SUPERVISING MECHANICAL EN R
OF PERMITT
PERMIT VALIDATION CK M o CASH
PLAN CHECK VALIDATION CK M o CASH
( ti� 9-7 3 01 RPR 16 5 D 5.00- 11
76A667 (CE 817) 1/7S
h
APPLICATION FOR PLUMBING PERMIT {�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER �y
BUILDING AND SAFETY DIVISION BUILDIADDRES�v��
MAKE CHECKS PAYABLE TO AJ
HARVEY T BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPEI NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM FEE �`�
OWNER
WATER CLOSET � MAIL
BATH TUB 200 ADDRESS ® �'
SHOWER CITY ,@ ®�I TEL NO 0
LAVATORY 77 CONTRACTOR fJ t /el
SINK 200 l ADDRESS a
DISHWASHER 200 CITY ,gym t!ze � TEL NO,,ril�ff A07
CLOTHES WASHER 200 STATE CLIC
LASS
G)
SWIMMING POOL RECEPTOR 2 00 LICENSE NO
DISTRICT NO GROUPZONE PR ESS D BY
0(LxLAWN SPRINKLER SYSTEM 200-
x
WATER HEATER 2.GQ- 7� INDUSTRIAL V
WASTE APPROVAL a�
GAS SYSTEM OUTLETS INSPECTION RECORD
V
OUTLETS OVER
5 PER SYSTEM 30 z
O
H
v
W
CL
f/7
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 1 00
TOTAL FEE
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant 7 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
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST27
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I A E LEGAL OWNER OF AND NTENb TO
RESIDE IN THE ABOVE DES E R DENTIAL P P
FINAL
SIGNATURE _
OF PERMITT
PERMIT VALIDATION CK M o OCAS.
PLAN CHECK VALIDATION CK M 0 CASH
6,4 0',n-JUL 24 u 1 1.7 5 A98