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Home My Public Portal About5335 CLOVERLY AVE_Plumbing__ 7GA667•CEV817 4-64 APPLICATION FOR PLUMB G PERMIb COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIMION ADD DRESS J 2-?S Cl— L JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN 4NEA ESTT NU7�77 FIXTURE OR ITEM EACH FEE OWNER / /P/df/3 ER CLOSET $I 25 2 C MAIL H TUB 125 ADDRESS CITY TEL NO WER 125 Z ATORY 1 8S ® CONTRACTOR / SINS 1 25 ADDRESS 59�J 6 0,o,,0 L��r DISHWASHER 125 CITY�� G �/ TEL NOCON STATE LAUNDRY TUB 125 REGISTRATION NO 2Z,5- 76 7 COUNTY ❑ CLOTHES WASHER 125 DISTRICT NO GR9"p ONE �P�WSSED)By WATER HEATER 150 } GAS SYSTEM OUTLETS a 1 G INDUSTRIAL AP ROVAL O OUTLETS-OVER-5 PER SYSTEM 30 INSPECTION RECORD U 9A6 —o W bL I A( R 4) W i a CrJ o-n d v e,,r' APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK 7 ROUGH PLUMBING •*,� y ,� TOTAL FEE I� GAS PIPING 1 HEREBY ACKNOWLd DGE THAT i HAVE READ THIS APPLICATION GAS VENT ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER 6 Ga PLUMBING _ I HEREBY CERTIFY THAT I AM PROPER RE ISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGEL COU AND STATE OF GAS TEST Y r CALIFORNIA OR THAT I AM THE LEGA WNER AND IN END TO RESIDE IN THE ABO EDESCR ED DEITIAL OPE UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL a LIDATION ROBERT A W OD C M O CASH SUPERVISING MECHANICAL ENG R LAU-0 3 3 9 5:p JuL, 7 5 D 1 5.0 0 r WORKERS"COMPENSATION-DECLARATION + APPLICATION FOR PLUMBING PERMIT I hereby offirm that I have a certificate of consent to self 200026 DPW 6/87 insurp, or a certificate of Workers' Compensation Insurance, 76AS67A or o certified copy thereof (Set; 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS "Policy No ` Company ❑ Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING V Certified copy is filed with the county building inspec- ADDRESS J �L0 �z L tion department NUMBER FIXTURE OR ITEM � @ FEE LOCALITY Date Appligont WATER CLOSET NEAREST e " CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER LA esti (This section need not be completed if the work Involved by MAIL 2 the permit Is for one hundred dollars ($100)or less ) LAVATORY y ADDRESS ��3 [ U Va C V R I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner SINK CITY TIdL NO as to become subject to the Workers'Compensation Laws DISHWASHERF CONTRACTOR 0 at. &0 Applicant CLOTHES WASHER ADDRESS t CE TO APP ICANT If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY TEL NO with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO SS LICENSED CONTRACTORS DECLARATIONgl&;RICT NO SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS / (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is In full force and effect 5 PER SYSTEM FINAL 1 VALIDATION Off? License Number Lic Class DATE Q FINAL U Contractor Date BY 0 O, ❑ I am exempt under Sec W B 8P C for this reasonD.. Plan check fee ® J Cn Date Z PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant r SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION Name 1'ti�T.s I hereby off irm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5 Business and 337117 3`1 c-t Professions Code) City Tel No ��'x. ❑ I, as owner of the property,^will do the work and the ITEMS structure is not intended or offered for sale (Section ® TOTAL 35 - 50 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY iHECK 35.50 1 hereby affirm that there is a construction lending agency for f HANGE .00 the performance of the work for which this permit is issued (Sec 3097 Civ C ) y' Lenders Name 5/11/911 t . P Lenders Address = }1619 1 M 8a 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 property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of P rmittee Date � d7 PGM SETS 12 44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY b; COUNTY OF LOS ANGELES PLUMBING 1 Wm J FOX ,CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PE(R�MIT NO COMPLETE ROUGH FIXTURES v e / �/ ��+ HEATER CESSPOOL H SEPTIC TANK REEC�IVED BYE READY FOR DATE ISSUED — FIRST INSPECTION GAS MISCELLANEOUS t �/ APPLICANT FILL IN HEAVILY OUTLINED-PORTION ONLY -JOB NAME r ADDRESS a i 6►�� ^ m m �ADDRESS j"4' LOCALITY yd-� A � O 1 ' /� VI NEAREST 'J CITY r (/ _ �" TEL NO � CROSS ST IL - COUNTY F ' - CERT No EXPIRES CN NAME LOCATION OF SEPTIC TANK,-OR CESSPOOL, Z MAIL '3 ADDRESS ` , NORTH r T - ,CITY TEL No IAM THE-LEGAL POSSESSOR-OF THE ASOVR,LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION PLUMBER , I AM THE LEGAL OWNER OF,THE PROPERTY DESCRISKD ABOVE OWNKR CORRECTIONS SOUTH a DESCRIPTION OF WORK t PATH TUB FURNACE ~ _ _ a 0 /+SHOWER ^ISHWABHER c LAVATORY REFRIGERATOR- 17 r s ITCHEN SINK WATER SOFTENER --FLOOR SINK SAND TRAP LOP SINK-- FLOOR DRAIN WASH TRAY URINAL _- APPROVALS ` WATER CLOSET DRINKING FOUNTAIN DATE INeP[cTOR B MAY[ /—WATER HEATER CENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN OUTL `GAS PIPING I I , GAS VENT V CESSPOOL °-� I I TOTAL NUMBER OF FIXTURES -SEPTIC TANK CESSPOOL SEPTIC TANK SEWER I 4 I TOTAL FEE v I 0-6 FINAL CO NOTIFIED � F[NAL D B S-17 25M SETS 12-45 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �L��g' ' Wm J FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO GROUP i ZONE PERMIT NO ROUGH FIXTURES COMPLETE / HEATER CESSPOOL L4SEPTICTANK RECEIVED BY READY FOR DATE ISSUED y FIRST INSPECTION GAB MISCELLANEOUS q 7 -4",-KAPPLICANT FILL IN HEAVILY IpOOUTLINED PORTION ONLY nf, JOB NAME A-1 E^-a Si �`l � ( ��'I P + �`y ADDRESS m 3558 ''a,t ADDRESS LOCALI y. Dipauaidelta to d l UlYt id / NEAREST .JCITYTEL NO CROSS 9T / IL COUNTY CERT No EXPIR m NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL No I AM THE LEGAL POSSESSOR OF THE ABOVE LOB ANGELES COUNTY CERTIFICATOF UALIFICATION PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER CORRECTIONS t SOUTH - 4 DESCRIPTION OF WORK cz BATH TUB FURNACE a HOWER DISHWASHER C LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN LCESSPOO RAY URINAL APPROVALS CLOSET DRINKING FOUNTAIN DATE INGPECTOR'B NAME HEATER DENTAL LAVATORY ROUGH PLUMBING GAB SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL UMBER OR FIXTURES SEPTIC TANK L SEPTIC TANK ggwgR TOTAL FEE UTILITY CO NOTIFIED I ��.� FINAL 7GA667 OBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY IN n mm COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER DISTRICT NEI FOR APPLICANT TO L OR P O O c /J_[j/ PLUMBER 1 REC,,E E HY READY FOR DATE ISSUED q 7/- / FIRST INSPECTION ADDRESS / y�O /��.u �/ r CITY �e-yrl/��e CI( NG TEL. NO T G d�Z ADDRESS (� V COUNTY LICENSE NO EXPIRES LOCALITY NEAREST PERMIT FEES CROSS ST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 1 MAIL WATER CLOSET(TOILET) @ 050 $ ADDRESS .t BATH TUB @ 050c I Ty ZOTEL No /Q.-r 6 416/2 SHOWER @ O 50I 1 HEREBY CKNOWLED E THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 050 APPLICATION AND STATE AT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 050 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER i OF THE RESIDENTIL PROPERTY DESCRIBED A OVE. GAS SYSTEM--z—OUTLETS @ O SO SIGNATURE OF 17 �I WATER HEATER @ O 50 PERMITTE SLOP SINK @ O SO INSPICTION RECORD FLOOR SINK @ 0.50 1 FLOOR DRAIN @ 0 50 s DISHWASHER @ O 50 DRINKING FOUNTAIN @ O 50 URINAL @ O 50 Q HOUSE SEWER @ O SO Z I9 MISCELLANEOUS . O � e APPROVALS DATE INSPECTOR'S NAME t ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 100 CESSPOOL SEPTIC TANK SEPTIC TANK / DRAIN ( ) PIT ( ) @ 1 00 SEWER / PERMIT I 1 00 GAS TEST , ✓ L" UTILITY CO NOTIFIED TOTAL FEE FINAL 76AG67 D68 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER DISTRICT NO GROU ZON PERMIT . FOR APPLICANT TO FILL IN PLUMBER/�-a S, C a r-7,7,t a RECEIVED BY READY FOR/ DATE ISSUED L_ FIRST INSPECTION ADDRESS I BUILDING CITY lb/e- TEL No 7 > Of 1 ADDRESS _ COUNTY LOCALITY LI NSE NO EXPIRES - NEAREST PERMIT FEES CROSS ST _ NUMBER TYPE OF FIXTURE OR ITEM FEE , OWNER J MAIL G/ & WATER CLOSET(TOILET) @ 0513 !$ ADDRESS O(o BATH TUB @ 050 CITY TEL No /4 SHOWER @ O SO 1 HEREB ACKNOWLED E THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN B114K @ O 50 AND BTATE LAWS REGULATING PLUMBING I CERTIFY THAT [_POSSESS THE ABOVE VALID LOS R TRAY @ 050 ANGELES COUNTY LICENSE, ORr�I AM THE LEGAL OWNER 1� GAS SYSTEM OUTLETS @ O 50 SI S THE RESIDENT PROPE DESCR �ABOVE. SIGNATURE OF WATER HEATER @ O 50 PERMITTED SLOP SINK @ O 513 INSPECTION RECORD c FLOOR SINK @ 0.50 FLOOR DRAIN @ O 50 DISHWASHER @ 050 DRINKING FOUNTAIN @ 0513 URINAL @ O 50 Q HOUSE BEWER @ 13511 Z O MISCELLANEOUS _ O APPROVALS DATE INSPECTOR'S NAM[ { ROUGH PLUMBING GAS PIPING �'` i/ i GAS VENT CESSPOOL @ 700 CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) @ 1 00 I SEWER PERMIT OD GAB TEST UTILITY CO NOTIFIED TOTAL FEE �j° FINAL V