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Home My Public Portal About4926 CLOVERLY AVE_Plumbing__ 76A667-CE4817 6 65 APPLICATION FOR PLUMBING RMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING 7 JOHN A LAMBIE COUNTY ENGINEER ADDRESS COLEMAN W JENKINS SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $125 MAIL DATH TUB 125 ADDRESS CITY f/ TEL NO SHOWER 1 25 LAVATORY 125 CONTRACTOR SINK 1 25 ADDRESS DISHWASHER 125 CITY TEL NO STATE LIC LAUNDRY rUB 125 LICENSE NO CLASS CLOTHES WASHER 1 25 DISTRICT NO GROUP ZONE �,XPRESSEDSYWATER HEATER 1 50 � 9 GAS SYSTEM OUTLETS 150 INDUSTRIAL D- WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM 30 I INSPECTION RECORD A V e w k-- . a- V) Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE _0 GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTE FINAL LIDATION 4 CK M O CASH �ALo 8 8 5 7 JR] 18 5 D 3.50- a u A667A ICE S17B) 11/76 f .r APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM @ FEE ADDRESS r � WATER CLOSET Y a U LOCALITY v BATH TUB NEAREST CROSS ST SHOWER �� C,((J OWNER LAVATORYMAIL t U ADDRESS SINK1 CI !TEL O 3 DISHWASHER CONTRA OR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY O LAWN SPRINKLER SYSTEM ' STATE IC WATER HEATER LICENSE NO LASS GAS SYSTEM OUTLETS DI�T�JC SST NO� �UP NE PROCESSED B OUTLETS OVER 5 PER SYSTEM INDUSTRIAL 9L WASTE APPROVAL V INSPECTION RECORD In O FUS O. Vf Plan check fee PLUMBING PERMIT ISSUING FEE$ 4 Sr- TOTAL FEE Z$ SF7 Plan check applicant APPROVALS DATE INSPECTOR S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING r -77 GJt44i S'�'+w City Tel No GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 'GAS TEST LEGAL OWNER OF AND INTEND TO RESIDE I THE ABOVE DESCRIBED RESIDENTIAL L ERTY UTILITYCO NOTIFIED cATURE � (PERM ITT INAL Aj PLAN CHE VALIDATION CK M Q CASH PERMIT VALIDATION CK M o CASH 3 7 6C'--AUG 4 5 d �.J� 0 � 3 os s �r 76A667-CE917-8-58 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A LANMIE, County En eer ADDRESS CASSATT D GRIFFIN, Supt of Building LOCALITY FOR APPLICANT TO FILL IN CROSS ST l 7N0/\r- CONTRACTOR NUMBER FIXTURE OR ITEM OWNER WATER CLOSETBATH TDB ADDRMAILESS ,� SHOWERLAVATORY SINKADDRESS DISHWASHER CITY LAUNDRY TUB CONTRACTOR S STATE El COUNTY ED CLOTHES WASHER DISF::j GROUP ZONE SSED BY WATER HEATER GAS S INDUSTRIAL / WASTE APPROVAL INSPECTION RECORD � v �v V �t /3-s �-. ► r�GL I APPROVALS ER Mod OR F PDn URE $ 3 DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 2 CO ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT r AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER �`R O v / --7- At WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES �- I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTI PROPERTY SIGNATURE i» FINAL OF PERMITT E Or VALIDATION mm ROBERT A WOOD SUPERVISING MECHANICAL ENG R CK M O CASH T-0e 1 0 8U; Ov .25 5 A 5.00 7BA667-CE817-8-58 APPLICATION FOR PLUMBING PERMIT COUNTY 1 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING C JOHN A LAMBIE. County Ea weer ADDBESS [J CASSATT D GHIFFIN,Supt of Building LOCALITY- —I-- FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAM / BATH TUB DES AD RS J-� % (,;CIZ l SHOWER CITY NO LAVATORY CONTRACTOR SINS ADDRESS DISHWASHER CITY TEL NO CONTRACTO STATE [0:1LAUNDRY TUB REGISTRATIO NO COUNTY ❑ CLOTHES WASHER DISTRICT NO GROUP ZONE P SSED HY WATER HEATER 1:5- GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS @ $1 00 PER ITEM OR FI%TUHE $ DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT2 00 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT t HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY SIGNATURE FINAL OF PERM ITTE ROBERT A WOOD Or VALIDATION SUPERVISING MECHANICAL ENG R CK H O CASH ~ arc S 2 3 7 1 NOV 3 0 5 A 300 r WORKERS COMPENSATION DECLARATION F, " {20 0026 DPW a/87 APPLICATION FOR PLUMBING PERMIT, N I he'rreby affiirm that I have a certificate of consent to self m' 76A667A< - - " sore or a�erwficate of Workers Compensation Insurance ora CE 817(REV 8/86) +`certified copy thereof (Sec 3800•Lab'C ) COUNTY�OF LOS ANGELES ADEPT OF PUBLIC WORKS Poky No Company, r� ,Certified,copy is hereby furnished a lnrt ` a I1 FOR APPLICANT TO FILL IN PRINT OR TYPE ; t' BUILDING d a a ` ;Certified copy is filed}with the county building inspection A ( ) ADDRESS' Fes' `0/0 0 0I' / ' NUMBER +^ FIXTURE OR ITEM,+ a� (al FEE,d LOCALITY dep6rtment` " �' f - WATER CLOSET , Applicant t P >NEAREST t' 4 BATH CROSS ST' (,(� el, ,CERTIFICATE,OF`EXEMPTION FROM WORKERS " ' w ¢ F"E_ , s + COMPENSATION INSURANCE 4 S " SHOWER OWNER v `t '' Y � _ - (Thi_s`'section'need not be completed if-the work involved by the perrmit is;for one hundred dollars ($100)or less ); LAVATORY t` ADDRESS MAIL3 u` ^�` I certify thpf'.in the performance of'the work for which this per- - SINK 31 - A `` �' � f mit is issued*I shall not employ any ersonVin ny manner's) u - ! ,CITY, TEL NO as t e e s b"lett to the Wor s om io " t t DISHWASHER " 1�100 CONTRACTORS D ' n CLOTHES WASHER _ fy TICE AP ICA`NT I terLmakirg°this Certificate'of Ex- _'" "* t N r•e rk ' 1 , = A.o _ ADDRESS ° ,' � `CR � _ SWIMMING POOL RECEPTOR p" emption you should become sublect ro the Workers Compen- ; a w CITY y Y _ _ TEL NO sation provisions of the Labor Code you must forthwith comp- t , LAWN SPRINKLER SYSTEM I with such'provisions or'this permit shall be deemed revok- - Y P, P _ STATE y �� LIC ed— a- , - - ^ '; ,„ gWATER'HEATER M v" LICENSE NO - •' 6, r CLASS„ W r,'' ,L "LICENSEDL,CONTRACTORS DECLARATION - g, DISTRICT NO NI! ED� ,r �` GAS SYSTEM q' OUTLETS" �° `(�' / �.^, v I hereby affirm that I am_licensed unde,provisions of Chapter" ! IT_9(commencing with Section 7000)of Division 3 of the Business < OUTLETS OVER and Professions.Code and my license is in full force and`ef 15 PER SYSTEM FINAL v VALIDATION V , fect F t _ <''' DATE License Number'' Lit Class f 4 U FINALS Contrbctor - Date BY ` a I,ami exempt under Sec W CL F B 8P C for-this reason p Plan check fee " Co Date r 110. PLUMBING PERMIT ISSUING FEE$ 50• a i Signature TOTAL FEE D 50 `z f S ' v SINGLE FAMILY e HOME OWNER-BUILDER DECLARATION PPlan check aPhcant c t r i 'v_ < , ., s " ." s in ., /��(�^�• a r I hereby affirm that I am exempt from the Contractor s License s Name,' _ " - �: L ° h �„ AC i e r Law'for}the following reason (Section 7031 5 Business and " + y�7 Professions Code)" ` ` Address`' `a= _ ' , a ,74J( {} r� Y d 28D 58 0,. N's t o _ ' Ate` 'owner of the property will do,the work and the Gty Tel No, r -01ITctur'e is not intended,)r offeredfor sale'(Section 7044- r . T �.iness and"Profess,ans CoderTY�1� m19� "CONSTRUCTION LENDING AGENCY6 '23.50` V .' . y ' " v F icy i� — � ,f��YI� t ' -0 I hereby'affiirr that'tF ere'i"a construction lending agency for { 4 i ;, + ' , , '�, !s <y ° " e z 1 r _ CHAWE %s I](�, , ,,the perfarmance of the work',for which this permit-is issued `� " e 'r" futill� ' (Sec�3097;Gv C') -, Lender s Name Q�-0001 7/19/V? Lender s�Address �� ; _ T"�` i ;,i r. ' + E y' �f ' , 5794 1 AM11:12 I,certify`that,l'have read,this applicatiori and state that the above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing 'arid hereby �' o k 4r r t s It authorize representatives of,this County to enter upon tFe + x e a�S'igg me 1 0perty pectpurpos SEE'REVERSE FOR EXPLANATORY LANGUAGEr y ermi tee Da