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HomeMy Public PortalAbout5725 CLOVERLY AVE_Plumbing__ '7eAS67 17 5-50 19 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT GRRO�UP I ZONE PERMIT N� PLUMBER ,/'/ RECEIVED BY READY FOR DATE ISSUED -7 y FIRST INSPECTION ADDRESS �.,� t+� CITY��NO-" il�lA' J�� BUILDING �w�(�TEL NO���� ADDRESS i COUNTY LOCALITY LICENSE NO EXPIRES - NEAREST PERMIT FEES CROSS ST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ O 50 $ ADDRESS BATH TUB @ O 50 I CITY TEL NO SHOWER @ O 50 I 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ O 5o APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ o Sol STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ o 501 ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER GAS SYSTEM OUTLETS @ O 501 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOYE SIGNATURE OF WATER HEATER @ O 501 PERMITTE � SLOP SINK @ o Sol INSPECTION RECORD FLOOR SINK @ O 50 FLOOR DRAIN @ 0 50 DISHWASHER @ 0 501 DRINKING FOUNTAIN @ O 50 URINAL @ O 50 .J HOUSE SEWER @ O 50 I �v Z MISCELLANEOUS I I O rr O APPROVALS DATE INSPECTOR S NAME ROUGH PLUMBING GAS PIPING ` GAS VENT CESSPOOL @ 1 00 ( CESSPOOL SEPTIC TANK ISEPTIC TANK cy DRAIN ( ) PIT ( ) @ 1 00I SEWER 7 f,/,r,. --� L �/ PERMIT I 1 00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE I $ I6 FINAL 76A667 17 5-49® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY OPOLUMBING 1 COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO p PLUMS E Q E 'La(,I,LFL=���` � Trli 2 - RECEIVED BY READY FOR FIRST INSPECTION DATE ISSUED ADDRESS 'rL. Lai BUILDING /�1 CITY L NO ��'" 6 t^ ADDRESS f Ae le COUNTY ,�yy ✓ /�- LOCALITY LICENSE NO 7 EXPIRES N NEAREST PERMIT FEES CROSS ST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Ov MAIL WATER CLOSET (TOILET) @ O 50 ADDRESS BATH TUB @ O 50 SV CITY TEL NO SHOWER Q O 50 - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS y LAVATORY WASH BASIN) Q O 50 t9a APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 �j STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50 'd ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIA j Y ROPERTDESCRIBED ABOVE GAS SYSTEM-.5— YSTEM OUTLETS @ O 50 �G SIGNATURE OF WATER HEATER @ O 50 PERMITTE SLOP SINK @ 0 50 INSPECTION RECORD FLOOR SINK Q O 50 FLOOR DRAIN Q O 50 7 DISHWASHER @ O 50 DRINKING FOUNTAIN @ O 50 C rte`lJ�'° Wt: 1C 4i c~-_tom©y' �',J C URINAL @ O 50 ,�� � Q HOUSE SEWER r @ O 50 Z MISCELLANEOUS ,'� �b/rj' 0 It r T¢4t7' APPROVALS DATE INSPECTOR S NAME ROUGH PLUMBING GAS PIPING lGAS VENT CESSPOOL Q 1 00 CESSPOOL SEPTIC TANK SEPTIC TANK I DRAIN ( ) PIT ( ) Q 1 00I SEWER PERMIT 1 00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE $ �� � FINAL /"' / 76A6 67 DB APPLICATION FOR PLUMBING PERMIT 1 DBS OF BUILDING AND SAFETY Department of County Engmeer County of Los Angeles BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS CASSATT D GRIFFIN, SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN I NEAREST CROSS ST OWNER DISTRICT NO GROUP ZO REAOY FOR INSPECTION MAIL 5' Y _ I ADDRESS J-+ K INDUSTRIAL CITY TEL NO n WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS i CITY74 ) O G LICENSE NO ��/LICENSE NO ��/ L�G� NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1 00 $ BATH TUB @ $1 00 SHOWER @ $100 LAVATORY (WASH BASIN) @ $1 00 KITCHEN SINK @ $1 00 DISHWASHER @ $1 00 LAUNDRY TUB OR TRAY @ $1 00 CLOTHES WASHER @ $1 00 WATER HEATER @ $1 00 GAS SYSTEM @ $1 00 APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE A GAS VENT I D HEREBY ACKNOWLEDGE THAT,I HAVE READ THIS APPLICATION HOT WATER HEATER ANJ) STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 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 OW ER OF THI ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPE5TY 7 SIGNATURE (�C� OF PERMITTEE FINAL JOHN A LAMBIE COUNTY ENGINEER LIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR tl O CASH E0 6 6 9 1 ,JUN 6 3 200 In r DEAE DBS 177 10 58 1 APPLICATION FOR 'PLUMBING PERMIT" ' DIVISION OF BUILDING AND SAFETY Department of County Engmeer County of Los Angeles BUILDING 7 JOHN A LAMBIE COUNTY ENGINEER ADDRESS Z CASSATT D GRIFFIN, SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST OWNER DISTRICT N GR O NE READY FOR INSPECTION MAIL Lam _ ADDRESS " - - - l� INDUSTRIAL CITY L NO WASTE APPROVAL PLUMBE INSPECTION RECORD ADDRESS / [!„7��2 P ✓ 6 eir s �A 1 CITY LICENSE NO NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1 00 $ BATH TUB - @ $100 SHOWER @ $100 LAVATORY (WASH BASIN) @ $1 00 KITCHEN SINK @ $1 00 DISHWASHER @ $1 00 LAUNDRY TUB OR TRAY @ $1 00 CLOTHES WASHER @ $1 00 WATER HEATER @ $1 00 GAS SYSTEM @ $1 00 APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING 'TOTAL FEE g2 I GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 1 AM THE LEGAL OWNER OF HE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY / SIGNATURE OF PERMITTEE FINAL JOHN A LAMBIE COUNTY ENGINEER ql� ALIDATION ROBERTA WOOD CHIEF PLBG INSPECTOR N 0 CASH 7 1 1 1 � JIJN19 3 0 in WORKER S COMPENSATION DECLARATION 20 0026 DPW 9/89 I hereby affirm that I have a certificate of consent to self insure 76A667A APPLICATION FOR PLUMBING PERMIT or a certificate of Worker's Compensation Insurance or a certified - copy thereof- S L ) Y � `"� P icy No< ompan �—Gr.,� COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING nCertified copy is filed with the count y�url i s on ADDRESS Me `papasent NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date GGYY Applrca WATER CLOSET NEAREST CERTIFICATE OF EXE TION FROM WORK BATH TUB B� CROSS ST COMPENSATION INSURANC ASSESSOR SHOWER MAP BOOK !J D PAGE D�� PARCEl�9 - -- (This section need not be comple d if the wor volved by the permit is for one hundred dollar ($100)or OWNER J LAVATORY I certify,that in the performance ork for which this permit MAIL' is issued I shall not employ an erson in any manner so as to SINK ADDRESS become subject to the Worker ' ompensation Laws DISWASHER CITY ,r L NO Date Applicant CLOTHES WASHER �v CONTRACTOR /. NOTICE TO A LICANT If after making this Certificate of Exemption yo should become subject to the Workers Compensation i SWIMMING POOL RECEPTOR rovisions oft a Labor Code ADDR p you must forthwith comply with such provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL �- I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER O (commencing with Section 7000) of Division 3 of the Business and STATE LIC LICENSE NO GAS SYSTEM OUTLETS CLASS �n V Professions Code and my license is in full force and effect DISTRICT NO PROCESSED BY 09 OUTLETS OVER O 5 PER SYSTEM License Numbe4�1 Lic ClassFINAL V DATE ��,� 3 VALIDATION uta Contrac ate y I am exempt under Sec FINAL C Z i BY , T B&P C for this reason t�-)iI r_t e s ate Plan check fee _ fym 3 307 70.65 Signature PLUMBING PERMIT ISSUING FEE$ I- jTE {1 TOTAL FEE TOTAL 70 - 65 Plan check applicant SINGLE FAMILY � _ i HEC K �I.�oy1 HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractors License Law r CHANGE r .[)[, for the following reason (Section 7031 5 Business and Professions Address _ Code) F] City Tel No V I as owner of the property will do the work and the structure I� �_):U�1 Lir` 5/51--' is not intended or offered for sale (Section 7044 Business and Professions'Code) ' 9057 't AM 11:24' CONSTRUCTION LENDING AGENCY ` I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 A \(;iv C) l Lender's Name Lender s Address I certify that I have read this application and state that the above information is correct I agree to om I with all County ordinances and State laws regu P bang and hereby authorize representatives o�tfi ounty to ante pon the above mentioned prope�fion purposes � �j SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Pbr ee Date /