HomeMy Public PortalAbout5034 & 5036 FARAGO AVE_Plumbing__ 76A7A
CE 817(REV 6/76)
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRES
NUMBER FIXTURE OR ITEM ® FEE
J- LOCALITY
WATER CLOSET
NEAREST
BATH TUB CROSS ST C G
SHOWER OWNE 6- Tr«�
LAVATORY MAILADDRESSC5 Z
2 SINK CIT 41 TEL NO
DISHWASHER CONTRACTOR ✓C! Q LvOlt S
-CLOTHES WASHER 'ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM STATEb LIC
WATER HEATER LICENSE NO rO O CLASS
GAS SYSTEM r OUTLETS 3 APPROVALS ATE INSPECTOR 5 ATURE
OUTLETS OVER / UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING ,J-7/01—
GAS PIPING
GAS VENT v
129
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL , - OVEQ
Plan check applicant PLAN
NNJCHECK VALIDATICi�Nq
Name ✓L�� �Gh� �� U �/ 4—T—mcr
Address o S-p X33,40 = /0 7/A/71 �jVd*
City &,,� Tel NQ S�/ - C
1HEREBY A KNOWLEDGE THAT I JAVE READ THIS APPLICATION AND ST TE
THAT THE ABOVE IS CORRECT AND AGRE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE ;20503A
LEGAL OWNER OF AND INT D TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY
C # 0 0 0 0 0 5
SIGNATURE o �7
OF PERM ITTE 2 0 0 5 8 7 5
D STRICT NO G PR ESSED BY o o o 5 a 7 56
C,�J 7 g
INDUSTRIAL 0 927
y
WASTE APPROVAL
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