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HomeMy Public PortalAbout5227 CAMELLIA AVE_Plumbing__ 76A667-CSl617 6-66 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION Buw1ma JOHN A. LAMBIE. COUNTY ENGINEER ADDAM COLEMAN W. JENKINS. SUPT. OR BUILDING LOCALITY FOR APPLICANT TO FILL IN Caosi�T. NUMBER lrou-UR[Opt ITEM EACH F[[ Cim WATER CLOSET Sim owmn LATH TUU im ADD>QSM SFA)WER 18 Cr" STEL 110. LAVATORY im gOXTRACTOR ` 6m im ADDRESS DMEWAAUM 133 CITY TKL NO. BTAT LIC n LAUADRY TUR im LICENSE NO. CIS (i CLOTSTI WASHES I$ DIGTRiCT NO. GROUP ZONE PROC[M[D ■Y 'WATER HEATER im } I. aAs 6YETE)[ OUTL=B WASTE APPROVAL O D_ 30 R USTRIAL OUTLETS OVER s PER s:sTT�c ao PSPECTi011 RECORD U w �0 tIl o_ Z APPROVALD DATE INEPECTOR•S■IGNATu RI PERMIT j Z 00 UNDER BLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING 1 IRID HY ACKNOWL[DS[ THAT 1 HAV[ RKAD THIS APPLICATION OAS VENT AND /TATs THAT TH[ AAKWK 1• CORIW.CT AND AQRii TO COMPLY WITH ALL COUNTY ORDIMAMCXB AND STATIE LAW RNMULATING FLUMMING. HOT WATER HEATER I FIIJ®Y CXPMPY THAT I AM PNOPKRLY RR41fTEM AHD/OR PLUMBING FIXTURES LICD/Sm AS MQUIMM MY LOS ANGXLZS COUNTY AND CTAT[ OP GAS TEST CALIPORNU. OR THAT I AM TIM LKOAL OWN" OF,AND INTEND TO Ri/ID[ IN.TH[AIOV[DF-§'RRlMD[ FROPKPITY. UTILITY CO.NOTIFIED SIGNATURE OF P[RMITT[[ FINAL -VAI.IDATION M.O. caws LAC0 7 7 5 7%- MAR 2 7 5 0 5.0 0- 7&M 7A -� CE 81N fREV,�% _6A667-(CE-B17);8-71 V APPLICATION FOR PLUMBI�GPM COUNTS OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION B U FOR APPLICANT TO FILL IN (PRINT OR TYPE) NUMBER FIXTURE OR ITEM • FEE OWNER C/ WATER CLOSET 1.76 MAIL BATH TUB- 1 .75 ADORES SHOWER .1 .76 CITY L. NO. LAVATORY 1,76 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.76 CITY TEL N CLOTHES WASHER 1.75 STATE LIC SWIMMING POOL RECEPTOR 1.75 LICENSE NO. CLASS DI `ICT E P E BY LAWN SPRINKLER SYSTEMA 1.76 Qy WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 I SPECTIO CORD OUTLETS OVER .30 �� L 6 PER SYSTEM W O., Vf z Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check epplloarrt UNDER SLAB WORK Name ROUGH PLUMING Address GAS PIPING City Tel. No. ' GAS VENT I HEREBY ACR OALEDSE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND ■TAT['THAT THE ABOVE 19 CORRECT AND ASR[[ TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY 'ORDINANC[1 AND STATE LAWS R[GUL.ATINO PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR UTILITY CO. NOTIFIED LICENSED AS RKQUIR[D ■Y LOS ANGELES COUNTY AND STAT[ OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF; INTEND TO RESIDE IN THE ASOVE D[1 [D R [NTIAL PRO E Y FINAL 51GNATURH OP PERMITTE PERMIT VALIDATION CK. M.0. CMH PLAN CHECK VALIDATION CR. N.O. CMH L n 5 C C 7�7 m 2 O D 4.75- .7 5N cu�-J 11 1V fU J� Q I 4 L- WURKFRS'COMPENSATION DECLARATION APPLICATION. FOR PLUMBING PERMIT LFereby�affirm that I Have a certificate of consent to self In 7�A�4;87 n ."e,�r a certificate of Workers'Compensation Insurance,ora 817 y Bias) dull certlfled copy thereof Se,'.-3800, Lab. ) policy No. a Company. COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Certified copy Is hereby furnished. l=pR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING' Certified tqp✓Is filedwith th ounrybulla' fl InapecNorr NUMBER FIXTURE Oil TEM Fff ADDRESS �� d e pa+rtf�n e nt. LO�ALm C� AplSllconf, ©' WATER CibSET(TOILET) TilST Dote �` _ - CERTIFICATE OF D(EMPTIO FROM.WORKERS' 0 BATH TUB CROSS SF.- 0 COMPENSATION I URANCE d OWNER (This section need not be completisd If-the work In"Ived by MAIL r the permlit Is for-one hundrid dollars($100)or less.) Q LAVATORY ADDRESS I?er*that Irr the performance of the work for which this per- mit IL-Issued, I shall not employ any person In any manner so SINK NW �` C TEL tFO. 6s fb becom&subject to the Workers' Compensation Laws.. ( ' DISASI ER CONTRACTOR Dale Applicant I CLoYHES WASHER O �� NOTICE TO APPLICANT: If, after making 1hls Certlflcate of Ex- e SWIMMING POOL RECEPTOR ESS emptlon,you shoold become sublet to the Wdrkers'Compen- CR-Y I TEL I f satlon provisions of the Labor Code,you must forthwith comp- 0 LAWN SPRINKLER SYSTE=M ly with-such provisions or this peurill shall he deemed revbk- STATE LLC ed. I WATER N�+TER O LICBlSE NO. CLASS LICENSED CONTRACTORS DECLARATION 1 �STRICT N' PROCt=55ED BY I hereby alflrm that I am licensed under provisions GAS of Chapter l SYSTEM Z, OUTLETS c 9(commencing with Section 7000)of Division 3 of the Buslness R� OUTLETS CHER and Profession$Code, and my license Is In full force and of- 5 PER SYSTEM FINAL VALIDATION >_ fect. DATE Z d Llcens&Number SOPC Llc. Class Fl ContractoTF1/ /.r K r7L�{rl g,- BY h O ' 1• f— I am exempt under Sec. W IL B.&P.C. for this reason Plan check fee , Date': PLUMBING PERMq ISSUING HE$ Slgngture - TgrAL FEE _ ;Y,9-'2'a-&ASINGLE FAMILY # o,o,o`.o}o 5 HOME OWN5R-BUILDER DECLARATION Plah check dppllcant I hereby affirm that I gm exempt from the Contrgctor'sllcense Name {('° ° 3.4.50 Law for the-following reason (Section 7031.5, Dusihem and o ° 0.3 5 0 5 Professions Code): AddrgO F1, as owner of the property, will do the work and the City Tel.No. 32 4 i 8 structure Is not Intended or offered for sale(Sectlon 7044, Business and Professions Code). , CONSTRUCTION LENDING AGENCY. 1 hereby affirm thQt there Is,q'Construction lending agency#pr the performance of the work for which this permit Is Issued (Sec, 3097, Cly. C.), 1 l Lender's NcIme /• Lender's Address I certify.that I hove read this applltatiorn and state that the above Information Is correct. I agree to comply with all County ► 0rdlnances and State laws regulating Plumbing, and hereby authorize rapresentafiv of this County.to enter upon the abo tloned o for Inspection purposes. SEF REVERSE FOR EXPLANATORY LANGUAGE Signure o Permlttee —�44Date WOFlKEITS COMPENSATION DECLARATION 20-OM DPW QIEQ hereby affirm that I have . certificate of consent to self Inure, 7&4,fWA APPLICATION FOR PLUMBING PERMIT or a certffloets of Worker's Compenatton Insurenoe, or a oertlfled copy thereof(Sec.3800 Lab.C.) ' Porgy No.�3$�, ry g'T�'T� �.t COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIY. ❑ Certified copy Is hereby fumbhed FOR APKJC ANT TO FILL N(PRINT OR TYPE) ADORL�B certified copy to flied with the cornty bulking Inspection FIXTURE LOCALITY department. N118FIi IXTURE OR rrBa � FEE p L// 3 /{int IC7� f l ✓�i� 1 WATER CLOSET NEAAEST CB3TIFICATE OF EXE)APTION FROM WORKS cFloss sr. ION COMPENSATINSURANCE BATH TUB Q (� � (This seodon need not be completed If the work Involved by the SHOWER rj MAP 100K PIPIKEo/3 PARC$ permit is for one hundred dollen($100)or lees.) Z LAVATORY 0 OWTJEl3 I oertlty that In the performance of the work for which this permit BAIL Is Issued, I shall not employ any person In any manner so as to SIM( ADDRESS become subject to the Workers'Compensation Laws. DISWASNEFI CITY Tt3_40. Dots APpkaM CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of I Exemption,you should beoome sukject to the Workers'Compensation SWIMMWO POOL_RECEPTOR _ pkovtelon of the Labor Code, you must forthwith comply with such ADDRESS provlalons or this permit shall be deemed revoked. LAWN SPRINKLER SYSTBA LICENSED CONTRACTORS DECLARATION CITY—T. ( TEL I hereby aftlrm that I em licensed under provisions of Chapter 0 WATM HEATER "ATE Lie. (commencing with Section 7000) of Division 3 of the Business and (RAS OUTLETS rNO. CLASS �� 8 Professions Code, and my license is In full force and effect DtBTRICT NO. BY ([ 6 P�8YH7H 08 0 IJcenee Number �_Lb.Clam ° FOALATION w t" DATE /Z 7 L U) mat« Ise F-1I am exempt under Seo Y� z B.aP.C.for role reason Plan check fee Dstr. Ssgnabre PLUMBING PERMIT ISSUING FEE$ 2 ❑ TOTAL FEE S SINGLE FAMILY Plan check app loant HOME OWNER-BUILDER DECLARAT)ON Name :i T I hereby affirm that I am exempt from the Contractor's Lloense Law 3307 S-2. 9r for the t Mowing reason (Section 7031.5, Business and Professions Address Code): E-11, Te+.No. 1 IT -� I, as owner of the property,will do the work and the structure '2 E Is not Intended or offered for sale (Section 7044, Business TIlT sem'" — and Professlons Code). , i�(� : 1 75 CONSTRUCTION LENDING AGENCY CAVE (r I hereby affirm that there Is a conetructlon lending agency for the �R�1 performanoe of the work for which this permit Is Issued (Sec. 3007, Civ.C.) ► —� :a�1 8I 41Y2 LTWs Name 4764 1 Wi T*? Lenders Address I dertffy that I havd read this application and state that the above ' In(prmatlon Is correct I agree to comply with all County ordinances and 8tate laws regulating Plumbing, and hereby authorize repreeentattves of this County to enter upon the above-mentioned p ".p SFE REVERSE FOR EXPLANATORY LAN(3UAQE 8lum re Perm ftbegf, Deft