Loading...
HomeMy Public PortalAbout9231 BLACKLEY ST_Plumbing__ 76.A6677 C6�6171REV X6/78) �5 1 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS' WATER CLOSET LOCALITY NEAREST r' BATH TUB CROSS ST c��' � ,A SHOWER OWNER LAVATORY MAIL g� ADDRESS SINK CITY �{ u / TEL NO DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL NO 7,7 7 7 7 LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS O� APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING d' O Cts, GAS VENT HOT WATER HEATER ®p PLUMBING FIXTURES luJ GAS TEST wbwb Plan check fee UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ ' `7 �� / /7� o TOTAL FEE 0 FINAL PLAN CHECK VALIDATION Plan check applicant Name Address City Tel�No- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE 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 r REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL O -a N PROPERTY 0- 0 a � SIGNATURE - rl 1 /.� � _' IV a O a N OF PERMITTEE / V CJ1 -"- '1'a a a 5D Q a N DISTRICT NO PROCESSED BY � O O a W -0 o o (A � �t INDUSTRIAL , WASTE APPROVAL o� APPLICATION gg,.y( PLUMBING p®��p�g/�►� ��ey(®��//yp D13S 17 APPLICATION FOR 9 Ll9.VBBING PE . ■MIT 1 oBs I7'DIVISION OF BUILDING AND SAFETY _ Department of County Engineer County of Los Angeles BUILDING JOHN A LAMBIE. COUNTY ENGINEER ADDRESS l CASSATT D GRIFFIN,SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN I NEAREST r OWNER , Z1 DISTRICT NO GROUP I READY FOR INSPECTION MAIL ` ESS 1 INDUSTRIAL CI Y EL N i WASTE APPROVAL PLUMBER INSPECTIAAON RECORD ^ f AQdftSS I �S "sfi- C ev C ue A•.ice ,.s�Il J�k�• ...._. CI EL N LICENSE NO NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1 00- $ BATH TUB @ $1 00 SHOWER @ $100 LAVATORY (WASH BASIN) @ $1 00 KITCHEN SINK @ $1 00 DISHWASHER @ $1 00 LAUNDRY TUB OR TRAY @ $100 CLOTHES WASHER @ $100 WATER HEATER @ $1 00 GAS SYSTEM @ $1 00 APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 1 OO ROUGH PLUMBING ! GAS PIPING TOTAL FEE 166 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 FIXTURES PLUMBING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GALS LICENSED AS REQUIRED BY LOS ANGELES COUNTY APO STATE OF CALIFORNIA OR T I AM THE L A OWNER 0 THE ABOVE UTILITY CO NOTIFIED DESCRIBED RES EN L PROP SIGNATURE OF PERMITT P FINAL JOHN A LAMB OUNTY ENGINE R VALIDATIO C4@ ROBERT A WOOD, CHIEF PLBG INSPECTOR -4Ca 9 2 0"( A AUG 14 3 2.0 C n X64 _ APPLICATION FOR PLUMBING PERMIT �t�hIVISION OF BUILDING AND SAFETY 1, Depaitrnent of County Engineer County of Los Angeles WM J FOX, COUNTY ENGINEER BUILDING CASSATT D GRIFFIN, SUP T OF BUILDING ADDRESS LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST OWNER DISTRICT NO GROUP4.7 E READY FOR INSPECTION MAIL /r T ADDRESS / `./ ` 0 INDUSTRIAL CITY TEL NO WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY TEL NO �` �� / q • �.I L,p ��� ,�1—'� n LICEN E NO �v l 1Si� 1m I—" k-1I'd 4. 6A 'b DD QIP NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) v BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER CAST .neon/ A&&& /IND,6A SL A8 TOTAL NO @ o so APPROVALS DATE INSPECTOR S SIGNATURE GAS SYSTEM OUTLETS @ 100 JJ�� UNDER SLAB WORK � 1 5`� eY 4 WATER HEATER @t 00 ROUGH PLUMBING PERMIT g 1 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 REGWLATING PLUMBING FIXTURES I PLUMBING 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST 2`I - LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO NOTIFIED y CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RES IDENTIA ROPERTY 011 .01!2 SOF PERM TTEE FINAL WILLIAM J. FOX, COUNTY ENGINEER ALIDATION .: 01 4 4-5r MR 11 3 2.00 'n BY >�r DEPUTY 76A667 DITS 17 12 54. �I APPLICATION FOR PLUMBING ■ EFt69 IT --' DIVISION OF BUILDING AND SAFETY ' Deportment of County Engineer!� �/qy /r�� J //�� //rr County of LOS 8 51 SS BUILDING FOX,WM J , COUNTYTY ENGINEER ADDRE CASSATT D GRIFFIN. SUPT OF BUILDING / LOCALITY �...G✓'I'7t',(���� FOR APPLICANT TO FILL IN -NEAREST CROss STOWNER lam+ ADDRESS `� DISTRI�NO I GP I ZQ.[�1.F..� READY FOR INSPECTION MAIL o CITY INDUSTRIAL TEL NO;jr LLL ! I WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY TEL NO LICENSE NO NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) $ BATH TUB SHOVyER ,��vv'iRtt LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO Cep 080 APPROVALS DAl E INSPECTOR S SIGNATURE GAS SYSTEM OUTLETS Q 1 00 G O UNDER SLAB WORK WATER HEATER 100 ROUGH PLUMBING PERMIT Y 1 00 GAS PIPING U TOTAL FEE 410 GAS VENT IO ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FI/TURCS PLUMBING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST Lns /�..A..._C-%— LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROE TSIGNATURE OF PERMITTEE FINAL Ll�1AA,ew WILLIAM J. FOX, COUNTY ENGINEER VALIDATION P j�.:IZo© 7 6 Ois m 2l 3 4.4 o in By DEPUTY A. 667—CE 817 8/68 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER B UILDING BUILDING AND SAFETY DIVISION JOHN A LAMBIE. COUNTY ENGINEER COLEMAN W JENKINS SUP T OF BUILDING FOR APPLICANT TO FILL IN (PR NT OR TYPE)NUMBER FIXTURE OR ITEM EACH FEEWATER CLOSET 1 50 BATH TUB 1 50 ADDRESS SHOWER 1 50 CITY TEL NO LAVATORY 1 so CONTRACTO SINK 1 50 ADDRESS & DISHWASHER 150 CITY 4/ TEL NO yg ---3V.r CLOTHES WASHER 1 50 STATE -_ f/L/ LIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 1 50 DISTRICT N GROUP zoup B d LAWN SPRINKLER SYSTEM 2 00 D U WATER HEATER 1 50 INDUSTRIAL Z WASTE APPROVAL o U GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD Lu OUTLETS OVER a_ 5 PER SYSTEM 30 C/"j Plan check fee 2)io of above See reverse PLUMBING. PERMIT ISSUING N LE R 2 00 TOTAL FEF APPROVALS DATE INSPECTOR 5 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT Clty Tel No HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING I HEREBY CERTIFY THAT I PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM LEGAL NER OF AND INTEND TO RESIDE IN THE ABOVE DEG B RESID TIAL PROPERTY FINAL / SIGNATURE JACK R. ALLEN, SUPERVISING CHANICAL ENG'R OF PERMITTEE ' PERMIT VALIDATION c lc M o C ASH PLAN CHECK VALID ION CK M O CASH t �'' 3 1. 2 51"� DEC 22 - 5 D 3.50- 14 f ` 1 76 A 667—CE 817 8/68 + 1 T APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER o2 / BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE. COUNTY ENGINEER ADDRESS ' COLEMAN W JENKINS SUP T OF BUILDING LOCAL FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS Si NUMBER FIXTURE OR ITEM EACH FEE OWNS WATER CLOSET 1 50 MAIL BATH TUB 1 5o ADD49 SHOWER 150 CITY NO LAVATORY 1 50 CONTRACT SINK 15o ADDRESS6" a Al DISHWASHER 1 50 C i�,r TEL NO CLOTHES WASHER 1 50 STATE11 ? LIC LICENSE NO v > CLASS SWIMMING POOL RECEPTOR 1 50 DISTRICT N GR OG• ZO E P O S BY LAWN SPRINKLER SYSTEM 2 00 _/� D T( i e�(�_ CD WATER HFATER 1 50 INDUSTRIAL zo WASTE APPROVAL GAS SYSTEM p5 OUTLETS 1 50 7 SP TION RECORD w _ OUTLETS OVER �/ �- 5 PER SYSTEM 30 / /� Z Plan check fee 2S% of above See reverse PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEF '0 APPROVALS DATE INSPECTOR 5 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Aciclre SS GAS PIPING GAS VENT CLDA Tel No HOT WATER HEATER EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES LL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST GEBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED D AS REQUIRED BY S ANGELES COUNTY AND STATE OF NIA OR THAT I AM E LEGAL ER OF AND INTEND TOIN TME ABOVE IBED E 1 TI L PROPERTY FINALURE JACK R. ALLEN, SUP RVt51NG C ANICAL ENG'R RMITTEE PERMIT VALIDATION CK M o CASH PLAN CHECK VALI 10 CK M o CASH 1 a4, 8 7 4 FEB 16 5 0 3.54— 4 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT Iahereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS J Lei Gl tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET �•� ��vs, �� 16-1Date Appliganl NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS STy►G COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less ) t LAVATORY ADDRESS 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers'Co atiCONTRACTOR Laws DISHWASHER ) T Date Applicant Uv CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL NO Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTR GT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS r Y (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER C and Professions Code,and my license is in full force an6effect 5 PER SYSTEM FINAL' DATE VALIDATION Oct License Number Lic Class 11 FINAL A Contractor Date BY W I am exempt under Sec N B 8P C for this reason Plan check fee Poo Date PLUMBING PERMIT ISSUING FEE$ f� Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION NameQv I hereby affirm that I am exempt from the Contractor's License Address G0 S' Law for the following reason (Section 7031 5, Business and ` 7 8 8 8 A Professions Code) City Teo,- f7l� 64-f- e N-,Z0 '73 W 1, as owner of the property, will do the work and the # oro a o o.5 structure is not intended or offered for sale (Section , 7044, Business and Professions Code) 2 ° o 3 2015 0 CONSTRUCTION LENDING AGENCY o yo`a 3 2 J Q U I hereby affi-rm that there is a construction lending agency for the performance of the work for which this permit is issued 1. 24,-82 (Sec 3097, Civ C ) Lender's Name Lender's Address 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 jaws regulating Plumbing, and hereby ri authoze repr7sentatives of this County to enter upon the above-me Y gr ; for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date APPLICAT9ON FOR P UMBING PERMIT WORKERS'COMPENSATION DECLARAT%p[� ,. � � �� I hereby affirm that I have a certificate of consrsnt to self 76A667A insure, or a certificate of Workers' Compensation Insurance CE 817(REV 10/81) 01 or a certifieu copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company ll Certified copy is hereby furnished 1Y FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed wrth the county building inspec- ADDRESS tion department NUMBER FIXTURE OR ITEM rte FEE LOCALITY Date Applicant WATER CLOSET NEAREST C— CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNERu`.(�0� (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any p rson in any manner SINK CITYT L NO so as to become subject to the Worker o nsation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTR4CT NO P ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM /--OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 5'0 and Professions Code,and my license is in full force and effect 5 PER SYSTEM _ FINAL Q DATE VALIDATION U License Number Lic Class 129 FINAL / Q Contractor Date BY U ElI am exempt under Sec � B &P C for this reason Plan check fee Date PLUMBING PERMIT ISSUING FEE$ S-0Signature TOTAL FEE S o 2 3 2 8 2 A Plan check applicant SINGLE FAMILY # o 0 0 0 0 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address 2 0 0 2 8'5 0 V Law for the following reason (Section 7031 5, Business and r 1 Pro essions Code) City Tel No o a o 2 a y O f� 1, as owner of the property, will do the work and the Q 630-83 structure is not intended or offered for sale (Section 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ C ) Lender's Name Lender s Address 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 jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mfor inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date