HomeMy Public PortalAbout5128 FARAGO AVE_Plumbing__ 76A667 CE817 12/59 \``'' /J / ` -
APPLICATION FOR PLUMB[ G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING pD ESAFETY RIVISION BUILDING
ADDRESS
JOHN A L MBI COUNTY NGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST Irl
CROSS ST
NUMBER FIXTURE OR ITEM
OWNER
Awn
WATER CLOSET MAII.
/
BATH TUB ADDRESS
SHOWER CITY ' TEL NO
LAVATORY CONTRACTOR
/ SINS ADDRESS
DISHWASHER CITY or TEL NOA777 72 s`
CONTRACTOR // STATE Lk
LAUNDRY REGISTRATIO NOS lv COUNTY ❑
CLOTHES WASH3ZR WATER HEATER Fi t6 TRT Q _ I GN/ Q/ BY
GAS SYSTEM INDUSTRIAL�Jf J� y'
WASTE APPROVAL
INSPECTION RECORD w
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Q $1 00 PER ITEM
OR FIXTURE $ 700 APPR VALS ATE ,I�NSSPECTTOR S SIGNATURE
PERMIT $ 2 00 UNDER-6i- 'WORK k Q A,D
TOTAL FEE —�i 60 ROUGH PLUMBING
/ GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
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 RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
OF VALIDATION ROBERT A WOOD
0 I D CASH SUPERVISING MECHANICAL ENG R
LAI'o7 l oc,�') +3UT L 5 D 1 n
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1210290020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
ILEGAL ID I FEES PAID 1 BUILDING ADDRESS 1
ITR 11497 UN 004 1 5128 FARAGO AV 1
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803527 1
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
18574 009 045 101 PERMIT ISSUANCE FEE 27 80 1 THOMAS PAGE 597 GRID D4 LOCALITY TEMPLE CITY CAI
113 DISHWASHER(S) 1 00 FIX 16 20 I
(TENANT 125 LAVATORIES/SINKS 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PLAN BY
145 WATER CLOSET/URINAL 1 00 FIX 16 20 110/29/12 SR
I TOTAL FEES 76 40 1
(OWNER f TEL NO i _ IFINA- DATE FINAL BY CODE
IFREY BARRY (562) 760 1826
8035 RING ST
ILBCH 908083226 1 I ESCRIPTION OF WORK 1
I 1 (REPLACE DISHWATER KITCHEN SINK AND WATER CLOSET 1
(APPLICANT TEL NO I -
I
ISAME AS OWNER I
I
1SPECIAL CONDITIONS
� 1
ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER I I
LIC NO
I (UNDER SLAB WORK 1
(WATER SERVICE I I
1 (PLASTIC Y/N METAL Y/N I
1ARCHITECT OR ENGINEER TEL NO
1 1 IROUG'1 PLUMBING
LIC NO 1 I
I I I
1 IGAS PIPING 1
I I I
IGAS VENT I
1HOT WATER HEATER I I
1 1
1 I (PLUMBING FIXTURES
I I I
(LAWN SPRINKLERS I
1 IGAS TEST 1 I
I I I
_ (UTILITY COMPANY NOTIFIEDI I1
1 1 ICWV I I
I 1 (GRAY WATER SYSTEM
I I I
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I I I I I I
I 1 I I I I
1 I I I I I
IREPORT ID DPR263 ROUTE TO BS0508 1
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