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Home My Public Portal About9144 BROADWAY_Plumbing__ 76A6671CL-8171-8-71 �' APPLICATION FOR PL B M ING P MIT n COUNTY OF LOS ANGELES u DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ' BUILDI ADDRESS 0 (^f LOC, P FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST G t' NUMBER FIXTURE OR ITEM @ FEE CROSS ST. WATER CLOSET 1.75 OWNER MAIL BATH TUB 1.75 ADDRESS tJ SHOWER 1 .75 CITY TEL. NO. LAVATORY 1.75 - CONTRACTORAM Al G SINK 1.75 ADDRESS �� H DISHWASHER 1.75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE LIC SWIMMING POOL flE OR 1.75 LICENSE NO. CLASS DIICT NQ.� G OU ZONE PR 5 Y LAWN SPRINKLER SYSTEM 1.75 „c, .J v V VVV O WATER HEATER 1.75 INDUSTRIAL _ 1 WASTE APPROVAL Q GAS SYSTEM OUTLETS 1,75 INSPECTION RECORD YJ OUTLETS OVER .30 Z 5 PER SYSTEM 0 U W G. N a Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE ' Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. Na. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY PLUMBING FIXTURES ' WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTI L TY DD. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF. ANO IN TO RESIDE IN BOVE DESCRIBED RES ID ENT IpL ROPERTT. FINAL SIGN OPG - / PERMIT VALIDATION CK. M.C. CASH PLAN CHECK VALIDATION CK. M.O. CASH seP21 ti :R., , . 4.75 _. _ 7e A667 8178/6.8 V— / 1 APPLICATION FOR PLUM _ ING PERM, COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGIIVEER BUILDING _ J BUILDING AND SAFETY DIVISION ADDRESS i✓D-a f(J JOHN A. LAM BI E. COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING ' LOCALITY - t FOR APPLICANT TO FILL IN (PRhT OR TYPE) NEAREST CROSS ST. Q _� NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 (' _ BATH TUB L'II ADDRESS v SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTOR /✓ / 0 h/ J SINK 1.50 ADDRESS -7) /f? ','V&j DISHWASHER 1.50 CITY,S,o CLOTHES WASHER 1.50 STATE �f tt LIC C LICENSE NO. %(7/ ? CLASS SWIMMING POOL RECEPTOR 1.50 DIBTRICT N P N`E CE6 LAWN SPRINKLER SYSTEM 2.00 .. 1 J U WATER HEATER 1.50 INDUSTRIAL ZO WASTE APPROVAL - GAS SYSTEM OUTLETS 1.50 INSPECTION ECOAD U w OUTLETS OVER 1 0_ 5PPER SYSTEM 'JG Z Z w /STv SWIM pol.1- Plan check fee 25° of above. See reYerse. PLUMBING PERMIT ISSUING FEE 8 "TOTAL FETE 00 APPROVALS DATE INSPECTORS SIGNATURE Plan cherk applicant UNDER SLAB WORK Name ROUGH PLUMBING Addre65 GAS PIPING GAS VENT Glly 1 el. 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 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF. O INTEND TO RESIDE IN, THE ABOVE 4EBC IBEO RESIDENTIAL P Y. FINAL SIGNATURE JACK R. ALLEN, SUP FVI511G CHANICAL ENG-R. OF PERMITT PERMIT VALIDA •ION cK. M.0. CASH PLAN CHECK VALIDATION CK. M.O. iAGo 6 ' N AUG 28 5 5__" 76A667 (CF'-B17)-.8-71 '� 'APPLICATION. OR PL I yBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUDDING ADDRESS LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TI(PE) ' 'NEAREST ' CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER 7/4 7{� (70 WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS J SHOWER 1.75 CITY TEL. NO. Q - LAVATORY 1.75 CONTRACTOR HYDAi6n!/0S SINK 1.75 ADDRESS 11H S /ji/ 9,&47A/tjj IA DISHWASHER A- DISHWASHER 1.75 CITY U�) L10-1111IW TEL. ND.33�J 4/296/ CLOTHES WASHER 1'75 STATE LICENSE NO.�CQ�aO.J C ASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GUDUP NE P OCESSFD BY LAWN SPRINKLER SYSTEM 1.75 / ...I ,1 WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL IL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD C v OUTLETS OVER 5 PER SYSTEM 'Ba Z C F U W G N Z Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE S 3 00 TOTAL FEE .i APPROVALS DATE INS PECTOR's SIGNATURE Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING /) Address GAS PIPING City Tel. No. GAS VENT HEREBY ACKNOWLEDGE THAT 1 HAVE REPOTNIS 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 TEST 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED / Y LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO RESIDE N ABOVE DEBCRIIAB/EF'OJy///R////[[//�� OEN IAL PR RT//yy. FINAL / SIGN OF� yYl��iL• � PERMIT VALID`TAT� tiW M.O. CASH PLAN CHEC VALIDATION CH. M.D. CASH (1 1�I 5 5 D 4 .7 5- .� '6A66' DB9 1' '-51 APPLICATION FOR PERMIT ' DEPARTMENT OF BUILDING AND SAFETY 1 L U 0 N COUNTY F LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER D FROUP ON . FOR APPLICANT TO FILL IN 71 PLUMBER • \ i RECEIVED BY READY FOR GATE ISSUED rr; / / / FIRST INSPECTION / � _L A ORCBB _` C,` Y�.�,�p� BUILDING TEL No. CITY ADDRESS �COUNTY EXPIRES LOCALITY / l/fv /T� (� 1 9E NO. NEAREST PERMIT FEES CROSS ST.//// /� //l/, //l ' �/ NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER VJC/rh O/J// V I 1�yy 'c7pMAIL y WATER CLOSET(TOILET) @ 0.90 8 52) ADORES. /J�Q�F"V�•! �C BATH TUB @ 0.50CITY l;;,nYl�XO �a a TEL No. SHOWER. @ 0.50 1 HEREBY ADKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 ,� D APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY TNATiJ POSSESS THEA OVE VALID LOB LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY CNBE, OR I AM W LEGAL OWNER GAB BY9TEM_pUTLETB 0.50 OF THE REBIDEX PROPERTY D IBEO/ABOVE. @ SIGNATURE OF WATER HEATER @ 0.50 PHRMITTHE SLOP BINK @ 0.90 INSPECTION RECORD�a _FLOOR BINK @ 0.50 FLOOR DRAIN @ 0.90 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL@ O.Sp F HOUSE BEWER @ 0.50 U_ MISCELLANEOUS J a 3 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.00 GAS TEST TOTAL FEE UTILITY CO.NOTIFIED S .� O FINAL v wVORKERStIhaveCOMPENSATION:te of consentTION - APPLICATION FOR PLUMBING PERMIT i. ,✓' .•20-0026 DPW a/BJ - J7 reby, affirm that I have a certificate of consent to'self in- 76A667A tiUl - sure,or a,eertificate of Workers'Compensation insurance,or a "CE 817(REV. 8/86) cg -died copy thereof (Sec. 3800 Lab:C.) COUNTY OF_LOS-ANGELES DEPT. OF PUBLIC WORKS PolicyNo. -• Company - ❑„ Certified copy is hereby furnished. -copy is filed with the county building.inspection FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Leri fled ADDRESS NUMBER FIXTURE OR ITEM LOCALITY ' T - department. � i� - @ FEE - - WATER CLOSET(TOILET) / �� L� C;/ Date Applicant r. NEAREST CERTIFICATE SOF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. "'COMPENSATION INSURANCE I . —1 1 t-' SHOWER' -' t ON ,BOy O/✓ •JRN (This section need not be completedvolved if the work inby MAIL - - Q the permit is for one hundred dollars (5100),or less.)' LAVATORY - ADDRESS / ' I certify that in'the performance of the work for which this Per- - - _ y - mit is issued, I shall not employ any person in any manner so SINK - CITY B , TEL. NO. �3 as to become subject to the Workers Compensntion.Laws. DISHWASHER / CONTRACTOR Date'Applicant CLOTHES WASHER ADDRESS �c NOTICE TO APPLICA T: If, ober making is Cert cote of Ex- ..SWIMMING POOL RECEPTOR ) emption,.you should become subject to the Work .,Compen- - CITY TEL NO, f-sation.provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM - - - ly with such provisions or this permit.shall be.deeri revok- _ STATE - LIC. 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 ' v 9(commencing with.Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM - FINAL � � O VALIDA ION > fect:- DATE O IL O License Number Lic. Class - U ` - FINAL AICH� i W Contractor - ' Date BY O . .❑ - H Gam exempt under Sec W B.BP.C. for this reason - a heck - Plan cfee - D _ rn 2 Date: - PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE -- - t SINGLE FAMILY Plan check d bcant HOMEOWNER-BUILDER DECLARATION - pp - - T. I hereby affirm that I am exempt from the Contractor's License Name - . - c, Law for the following reason (Section 7031.5, Business and i Professions Code): Address (:T.T c �• I;as owner'af the property, will do the work and the City Tel'. No. 3307 34.50 structure is not intended or offered for sale(Section 7044, { 1 ITEMS Business and Professions Code). -- CONSTRUCTION LENDING AGENCY - D - - TIBIAL t134 -50 hereby affirm that there is a construction lending agency.for - CHECK 34.9-0 the performance of the'work for which this permit is issued s - (Ser. 3097, Civ. C.). CHANGE ,OL) Lender's Name - Lender's Address - r 1 11 6/89 certify.lhot I havereadthis application and state that the L125 1 AM 11:as obove,information is correct. I agree to comply with all County _ D ordinances and Stote'Icwsregulating'Plumbing, and hereby authorize representatives of this County to enter upon the ' above-mentioned pr erty for inspection purposes, , . e SEE REVERSE.FOR EXPLANATORY LANGUAGE Signature"of Trmitle Dote _