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Home My Public Portal About5038 CLOVERLY AVE_Plumbing__ • D B S-17 25M SETS 6-46^ APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �L� ING Wm J FOX. CHIEF ENGINEER It NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT NO. ROUGHFIXTURES COMPLETE Y �` r G HEATER CESSPOOL I—I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED f /7 � ,a FIRST INSPECTION GAS MISCELLANEOUS (11 G APPLICA°yNT FILL IN HEAVILY OUTLINED PORTION ONLY ,g1�FrvSi JOB NAM 0MrO( ` ;��r�rSy h^-^�//�l'"` .'y�;� �.,_ ADDRESS fiT/!L1 -JIB t��/ ADDRHS fy�.�- / v� (�4, l+f �pi�"� LOCALITY �.��r L! '�A `I N''f!'1 I 1414.,fl NEAREST . 6CITY C �� TEL NO � CROSS BT Y� �t .U/► � /�, ,/ � biCEINO �� V EXPIRES .. Y NAME . RV ff TWOTION F S9 IC TANK, OR CE +POOL 2 MAIL 3 ADDRESS (�V� H ➢ �..< i(��s y NORTH O a•T v a i f CITY TEL NOVA c f')414 I AM THE LEGAL POSSESSOR OF ,THE ABOVE LOS ANGELES COUNTY CERTIFICATE'OF QU IFICATION- PLUM MER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED > ABOVE. ��la � 9v3/ 3 > `' - —fie/^'OWNER CORRECTIONS p SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE (7 0 ROWER DISHWASHER O AVATORY REFRIGERATOR _KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP GLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE Q IINNGPECTOR B NAM11 WATER H.MTER DENTAL LAVATORY {BOUGH PLUMBING METE GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT I I F ' CESSPOOL _4?— OTAL NUMBER OR FIXTURES i SEPTIC TANK I I CESSPOOI ¢EPTICTANK SEWER B TOTAL FEE UTILITY CO NOTIFIED 1 /,7- - � �® ' aU i FINAL �/ -A It/S I J D B S-17 25M SETS 6-46 ' APPLICATION FOR PERMIT `DEPARTMENT OF BUILDING AND SAFETY{ COUNTY OF LOS ANGELES �L �� Wm J FOX. CHIEF ENGINEER NkmG NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT NO 'ROUGH FIXTURES COMPLETE HEATER CESSPOOL I-I SEPTIC TANK RECEIVED BY READY FOR ATB ISSUED BY. FIRST INSPECTION _ - 4L GAS M ISCELLANEOU (�„ APPLIC_A T FILL IN HEAVILY OUTLINED PORTION ONLY JOB a, NAM ADDRESS ®� - 0 W m ADDRESS a 6s. LOCALITY NEAREST O TEL 0 CROSS ST No EXPIRES j 19 m NAME LOCAT OF SE ' C TANK, OR CESSPOOL Z MAIL 7 n3 ADDRESS NORTH O d CITY s TEL NO I A THE LEGAL POSSESSOR OF TUf J3BOVE LOS ANGELES COUNTY CERTIFICATE QUA F 1 PLUMBER I AM THE LEGAL OWNER OF THE PERTY DESCRIBfD ABOVE. N OWNER i CORRECTIONS SOUTH J DESCRIPTION OF WORK Z BATH TUB FURNACE L7 Q' SHOWER -DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP BINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR S NAME WATERATER DENTAL LAVATORY ROUGH PLUMBING METERGAS SODA FOUNTAIN OUTL GAS PIPING I i GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI SEPTIC TANK SEWER $ UTILITY CO NOTIFIND TOTAL FEE �j ®(� G "� FINAL / �/i - 76A667 17 S-49 ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ��MIMING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT O GROUP ZONE LPE MIT NO ce :--/atzk Co PLUMBER RECEIVED BY READY FOR DATE ISSUED �) FIRST INSPECTION ADDRESS / �* ,�Pi /�f/< y e �'� L BUILD o CITY onto T(a, Q kADD EISS e [ EL MMM s COUNTYLOCALITY -LICENSE NO EXPIRES PERMIT FEES STT 0 S NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER A MAIL WATER CLOSET (TOILET) @ O 50 $ ADDRESS Y"y BATH TUB @ O 50 ,Q 1 l CITY �� /7 04 TEL NO SHOWER @ O 50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING 1 VALID Los LAUNDRY TUB OR TRAY Q O 50 AN ELES COF PARTY DES IB OV E. 41!N R GAS SYSTEM OUTLETS @ O 50 SIGNATURE OF WATER HEATER @ O 50 PERMITTEE. SLOP SINK @ O 50 INSPECT16ti RECORD FLOOR SINK @ O 50 FLOOR DRAIN @ O 50 DISHWASHER @ O 50I DRINKING FOUNTAIN @ O 50 URINAL @ O 50 J� ,j / HOUSESEWER @ O 50 0 I z MISCELLANEOUS a lz I� r O APPROVALS r DATE INSPECTORS NAME r � ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @. 1' 00 ( CESSPOOL SEPTIC TANK SEPTIC TANK I DRAIN ( ) PIT ( ) @ 1 00 SEWER PERMIT 1 Lo GAS TEST UTILITY CO NOTIFIED /O TOTAL FEE I $ � I �� FINAL ( WORKERS' COMPENSATION DECLARATION 2DPW 4/87 APPLICATION FOR PLUMBING PERMIT 7 ` I hereby,;affirin that'I have a certificate-of'consent to self in- 76A6676A667A sure,,6a certificate of Workers'Compensation Insurance, or a CE 817(REV. 8/86) " certified copy thereof (Sec. 3800, Lab. C.). COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS. Policy No. Company " Certified copy is hereby furnished'CTI E FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ❑ Certified 'copy is filed with the county building inspection ADDRESS NUMBER FIXTURE OR.ITEM FEE department. { f"6o @ LOCALITY WATER,CLOSET(TOILET) Date Applicant �W - NEAREST CERTIFICATE OF EXEMPTION FROM RKE BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER SHOWER (This section need not be completed if the work involved by MAIL , the permit is for one hundred dollars ($100) or less.) LAVATORY ADDRESS certify that in thSINK e performance of the work for which tkis per- ' mit is issued, I shall not employ any person in any manner so CITY TEL NO.. as to become subject to the Workers''Compensation Laws. DISHWASHER CONTRACTOR 3.kik LIS Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emptioh, you should become subject to the Workers'Compen- CITY c TEL. NO. 'sation provisions of the Labor Code, you must forthwith comp- 'LAWN SPRINKLER SYSTEM, v I with"such_provisions;or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION 151SNO. _BROCESSED BY I hereby affirm that I am licensed under proaiisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the'Business OUTLETS OVER fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL f) VALIDATION DA E License Number Lic. Class, O U FIN � Contractor ' � Date B O I am exemp u er t A c. � B.&P.C. for•'this reason Plan check fee . Date: /U , PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLEFAMILY, HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name - Law for the"following reason (Section 7031.5, Business and Professions Code): Address . I, as owner of the property, will do the work and the City Tel. No. & structure is not intended or offered for sale(Section 7044, Business and Professions Code). pop. a -: e. r x �� - CONSTRUCTION LENDING AGENCY t i� C.28.5,F I hereby affirm that there is a construction lending agency for the`performance of the work for which this permit is issued00 (Sec. 3097, Civ. C.). Lender's Name' Lender's Address -- -' ;r, J._ -"r- s: i ,i a 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 laws regulating Plumbing,and,hereby authorize representatives.of this County to enter upon the above-mentioned pro erty for inspection purposes. 6 r q SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date 1