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Home My Public Portal About5219 FARAGO AVE_Plumbing__ DBS6I,ogg APPLICATION EOR P VSB INN PERMIT Y 1 ~DIVISION OF BUILDING AND SAFETY Deportment of County Engmeer County of Los Angeles BUILDING AVt JOHN A LAMBIE COUNTY ENGINEER ADDRESS ✓c CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICMT, TO FILL JX NEAREST CROSS ST OWNER DISTRICT MAIL I]� GROUP I ZZO E I READY FOR INSPECTION ADDRESS / a/,J/�� CITY TEL NO INDUSTRIAL WASTE APPROVAL PLUMBER `� INSPECTION RECORD ADDRESS CITY / TEL LICENSE NO NUMBER T PE OF FIXTURE OR ITEM FEE P WATER CLOSET (TOILET) @ $1 00 U m v BATH TUB @ $1 00 s SHOWER @ $1 00 g 11 LAVATORY (WASH BASIN) @ $1 00 616, ` n� KITCHEN SINK @ $100 J' r v AA DISHWASHER @ $1 00 2 LAUNDRY TUB OR TRAY @ $1 00 CLOTHES WASHER @ $1 00 WATER HEATER @ $100 GAS SYSTEM @ $1 00 APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK /0-/ ,ry PERMIT $ 00 ROUGH PLUMBING GAS PIPING TOTAL FEE 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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES y I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY TAT,- OF CALIFORNIA OR THAT I AM T LEGAL ER HE AB VE UTILITY CO NOTIFIED DESCRIBED RESIDENTI ROP T 101. SIGNATURE �An, n r OF PERMITTEE FINAL JOHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR CK M 0 CASH r [ACO 5 6 2 9u OCT 9 5 A 400 � T D' 17 12 64 DBS APPLICATION FOR PLUMBING PERMIT DBS 17 DMSION OF BUILDING AND SAFETY 1 Deportment of County Engmeer County of Los Angeles WM J FOX COUNTY ENGINEER BUILDING L"'� oe!�} 1E-/s�� 'g ti fj r CASBATT D GRIFFIN SUP T OF BUILDING ADDRESS LOCALITY 7; C FOR APPLICANT TO FILL' IN c EARS sT C � OWNER MAIL �7 /�7 /� DISTRICT NO GROUP ZONE READY FOR INSPECTION ADDRESS mfr A C V . I 1 I _� /p- e / INDUSTRIAL CITY • L9.. . TEL NO O / WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS I CITY TEL NO 0p {/ j��.� LICENSE NO O® r{t 0(/,C D ' /� f r --i/ // 0 yv NUMBER TYPE O FIXTURE OR ITEM FEE WATER CLOSET (TOILET) $ _ BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO @ 080 APPROVALS DATE INSPECTOR S SIGNATURE GAS SYSTEM OUTLETS @ 100 UNDER SLAB WORK WATER HEATER @ 100 PERMIT $ 1 1 ROUGH PLUMBING 00 GAS PIPING TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO NOTIFIED CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESID=APROPERTY SIGNATUREOFPERMITTEE -e [ FINAL WILLIAM J FOX COUNTY ENGINEER VALIDATION ` kC01 5 Q OS W14 3 - 2r BY Q � t � tl (vl 76A667 DBS 17 11 '16 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY L ' G 1 COUNTY OF LOS ANGELES WILLIAM J FOX, CHIEF ENGINEER DIS RJGROLIPM T FOR APPLICANT TO FILL INJ NO PLUMBER . RECEIVE5 � � � D BY READY FOR DATE ISSUED FIRST INSPECTION /�� /� ADDRESS �® kAIVII• Q A BUILDING CITY TEL NO ADDREBB 5219 Farago Ave• COUNTY LOCALITY 1LCENSE NO EXPIRES D� NEAREST Freer St. PERMIT FEES CRO88 BT HORT� 7�AS c MUErpt OWNER TT NUMBER TYPE OF FIXTURE OR ITEM FEE MAIL WATER CLOSET(TOILET) @ 050 111 ' ADDRESS As above BATH TUB~ @ O 50 c,Ty Temple City TEL. No SHOWER @ 060 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 1350 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 050 AND STATE LAWS REGULATING PLUMBING I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O SO ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OAS SYSTEMDUTLET9 @ O 50 OF THE REBIDENTjok PROPERTY DEB BED ABOVE SIGNATURE OF WATER HEATER @ O 50 PERMITTEE SLOP SINK @ O 5O INSPIMM RECORD FLOOR SINK @ O 50 FLOOR DRAIN @ O 50 DISHWASHER @ O 5O DRINKING FOUNTAIN @ O 50 URINAL @ O 50 Q HOUSE SEWER @ O 5O Z CJ MISCELLANEOUS 1— Water Softener 0 0 APPROVALS DATE INSPECTOR B NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ laO CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ) PIT ( ) @ 1 00 SEWER PERMIT 1 DD GAB TEST UTILITY CO NOTIFIED TOTAL FEE � r �- r0 FINAL` WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I tier h ffirm that I have a certificate of consent to self in- 76A666 DPW a/87 Q Y. R� 76A667A sre;, r a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy thereof (Sec. 3800, Lab. C.) Policy_No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS • Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET(TOILET) Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section'need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY v TEL. NO. as•to become subject to the Workers' Com ensati. Law DISHWASHERfl r I CONTRACTOR Date. Applicant 114,, CLOTHES WASHER NOTICE TO APPLICANT: If, after making thi C tificate of Ex- ADDRESS n �� emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR: sation rovisions of the Labor Code, you must forthwith comp- CITY TEL. NO. 7 �� p y P- LAWN SPRINKLER SYSTEM ly,with such.provisions or this permit shall be deemed revok- STATE UC. ed. WATER HEATER LICENSE NO, CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter ` GAS SYSTEM OUTLETS D [� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER o Cr� and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL I VALIDATION fect. --z-�/z L�E6 L'icDATE C 0 License Number b� . Class 0 U tP FINAL Contractor �� Date .'�'/ � BY � p., I am exempt under Sec. LLI ' B:&P.C. for this reason Plan check fee Date: 0. PERMIT ISSUING FEE $ a� Signature TOTAL FEE SI LE rA00<MILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and §:y Professions Code): Address ' `" I, as owner of the property, will do the work and the City Tel. No. )}`�r ; 711; structure is not intended or offered for sale(Section 7044, ! E s��' Business and Professions Code). ► T l_IT i iL s .210 CONSTRUCTION LENDING AGENCY "I hereby affirm that there is a construction lending agency for `_:H j. , the performance of the work for which this permit is issued {'_ iK%1C n f 3 (Sec. 3097, Civ. C.). " Lender's Name Lender's Address 4 _r _ A' _I n t I certify that I have read, this application and state that the , above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property fo nspection purposes. �yySEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per 'tee Date