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Home My Public Portal About6145 CAMELLIA AVE_Plumbing__ DEPARTMENT OF OOU= ENaINYER PLUMBING 1 DIVISION OF BUELDING AND SAFETY PERMIT APPLICATION OOTTNTY OF LOS ANGF7, BUILDING WILLIAM J. FDX, COUNT-1 ENGINEER ADDRESS FOR APPLICANT TO FILL IN LocALITY BUILDING NEAREST ADDRESS CROSS ST. D18TB1 OR UP ZONE PERMIT 1111 _ LOCALITY NEAREST T CROSS ST. E VED Y Ready for laE*wueo DATE ISSUED OWNER MAIL _ T INDUSTRIAL ADDRESS _, y7 C• L T01eA-S 7JR- WASTE APP OVAL CITY /CXv,^t—Le;z TEL NO. INSPECTION RECORD PLUMBER �,-ffW/Za0' ADDRESS CITY TEL N0. 10-37i p STATE LICENSE N0. I 'COUNTY J PERMIT FEES a z_ NUMBER M[ OF POCTURI OR MEM FTA Q WATER CLOSET(TOILET) a O.S1 $ Fo O BATH TUB • O SO SHOWER MO LAVATORY(WASH BAST ! 0.80 KITCHEN SINK O 0.16 LAUNDRY TUB OR TRAY 1.51 SLOP SINK O.Se FLOOR SINK 0.30 FLOOR DRAIN 9.3E DISHWASHER Q 0.D1 DRINKING FOUNTAIN f SSO URINAL 9.80 GAS SYSTEM OUTLETS ! 1.+10 WATER HEATER d 1.10 MISCELLANEOUS APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE GAS PIPING 1HEREBY AOKNOWLEDGE THAT 1 HAVE READ THIS APPLI. GAS VENT �Z CATION AND STATE THAT THE ABOVE 18 CORREOT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES t" I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOB ANGELES COUNTY GAS TEST M AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE ESCRIBEO RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNURE MI E „ FINAL 7' ' T6ASST DR91T 1/63 T S„ ATIQN I herebyaffirmthatOI i havegK oartificDECLARATION of conepto self :` APPLICATION FOR PLUMBING PERMIT more, or a certlflcate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No,.—Cofnpany © Certlfled copy is hereby furnished. FO APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING �/ ADDRESS GIAl4 '1- yjJ �i Certified copy Is filed%vitb the county building inspection NUMBER FIXTURE OR ITEM • FEE departm6nt. WATER CLOSET LOCALITY G Date Applicant Nr=AhaT BATH TUB CROSS 8T. .CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER WNER �L Gids section need not be �p let�ed if the work hrrotred LAVATORY ADD � r 'rte p by the permit is for ns ohnndro0 dollar ($100) or less.) 8 I certify that in the performance of the wrbrk fol wdich thisD18HWASHER peris bsvedi I lh&U ndt employ any person In any mannet mit CONTRACTOR 0 O to as to become subject to the,Worker' Compensation Laws. CLOTHES WASHER &V ADDRESS Data Date_ APpUr,-t SWWMING P'OOL-RECEPTOR 11J NICE`i'O APPL OTICANT:'If, aftar making this Cettlfleate of CITY TSL. NO. 5S Exemption, you should become subject to the Worker' LAWN.SRRINKLFR SYSTEM Compensation provision of the Labor Code, you must forth- STATE ? wtlr comply with such provisions or this permit 'sball be WATER HEATER LICENSE NO deemed revoked GAS SYSTEM OUTLET$ 151ST ]T NO. O ES$E Y LICENSED CONTRACTORS DECJ.ARATION OUTLET8.QVER I hgroby affirm tJut I am llcepsed under provision of Gbapter 6 PER SYSTEM 9 (coftmenging w(th Sectlon 7000) of Dtriston 3'of the Bud- FINAL noes and Ptofeadon Code, #nd my license is in full force and. DATE �Sl�� V.AL1DAla`FO effect. -FINAL Ltcense Number. Lie.Class T BY, Cgntractor Date, C] I am ezempt froin the licensing'requirements as I am a Plan cheek foe- licensed architect or a registered professional engineer PLUM-BI N G PE R M I T ISSUING FEE; acting In my prefeesional capacity (Sectiop 7051, lam' Ina"and Profession Code). TOTAL FEE 10 eoej Llc.or Reg.No. Data Plancheok applicant 10 -1 2 5 A HOME OWNER-BWLDER DECLARATION Name # o.o.o o 0 5 000LlI hereby affirm that Ism exempt, from the Contractor's Address 2 0,0 1000 Licama ceme I.aW for the following reason (Section.7031.5, Busi- CLr Tal.No. near and Prof6ssion 0 0 0 Code): 1 G 0 0& I, asowner f the property, am ezrlustrely contracting q 061 .0-81 With licensed contractor to conktruct the project , (Section 7044,Business and Trofesslops Code). CONSTRUCTION LENDING AGENCY I,l;erel?y 0firm that there Is a codstruction.lending agency for the performance of the work for widely this permit is issued(Sac.3097,Civ.C.). Lender's Name_ Lender's Address I certify that I have read this appllcafion orad state that the above information is correct.I agree to comply with all County SEE REVERE FOR EXPLANATO)tY LANGUAGE ordinances and $tgte laws regulating,Plumbitig, and hereby authorize repreegntstives of this County to enter up-oft the above-montioijed property for inspection purposes. 67-Y-i-I . Signature ofPermittee Date I