The URL can be used to link to this page

Home My Public Portal About6220 CLOVERLY AVE_Plumbing__ 1� 76A667-CE,ti817 6-66 APPLICATION FOR PLUMBING PER IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING J JOHN A LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W JENKINS SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CHORES ST. /L NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRA r 3INfi 1.25 ADDRESS DISHWASHER 1.25 CITY O�- �o Q� LAUNDRY TUB 1.25 STATE LIC LICENSE NCLASS CLOTHES WASHER 1.25 D_II�RICT N GR ZON P Y WATER HEA 1.50 GOUTLETS 1.50 INDUSTRIAL (L AS SYSTEM WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V 0 H V W CL N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 f 1 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 N� 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 RESID T L PROPE UTILITY CO NOTIFIED -.......-�" SIGNATURE dj/--- OF PERMI r FINAL V UDAnON ` CK M O CASH LACO 8 7 0 6 1 JAN 11 5 D 3.50- a 7ea6e7 17 B-ISO APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. PLUMBER •�INTCRBOTTOM RECEIVED BY READY FOR DATE ISSUED /jll �_� FIRST INSPECTION 1112 WESTMINSTER AVE. N'1' ADDRESS NIA BUILDING CITY TEL. NO. ADDRESS / ;,. :OVERL;Y_AVE COUNTY LOCALITY 2 20 LICENSE NO. I 1115 EXPIRES NEAREST PERMIT FEES CROSS ST. TSP me C oyy 8r_VD. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ O 501$ 50 ADDRESS .3612 Eo Levc VQ;c AyiE. BATHTUB @ O501 I 50 CITY ��e,'Qrj�Q� ,AL IF, TEL NO. SHOWER @ O 501 50 1 HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) @ O 50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 OSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUN LI E. R I AM TtW LEGAL OWNER GAS SYSTEM OUTLETS @ 0 SOI S GTHFiy E O IA OF DE - ABOVE. WATER HEATER @ O SOI50 PERMITTE SLOP SINK @ o so I SPECTION RECORD FLOOR SINK @ O 50 I , FLOOR DRAIN @ O 50 DISHWASHER @ O Sol DRINKING FOUNTAIN @ O 50 �` I F 'A}/ �1�V:1'�l'� ��I 1'1 �A� rn-• 1 URINAL @ 0.50 t� I ,y�t�( y �K l lTl T(1 t'V Y) QIH Q HOUSE SEWER @ O SOI L�5i A�J F I-D o Q _Z MISCELLANEOUS 1 h! J< YT ar I� :.S 0T WI<r;I -TkIi's h{nusE I 'Trf- is poij►2t F- 1 1 APPROVALS �yDATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING ✓ 1 I GAS VENT M CESSPOOL @ 1 00 I CESSPOOL _ SEPTIC TANK I SEPTIC TANK I DRAIN ( ) PIT ( ) @ 1 00 SEWER PERMIT 1.00 GAS TEST I I 10 UTILITY CO NOTIFIED 01 TOTAL FEE $ 5 I " L-1Yv FINAL •' WORKERS';COMPENSATION DECLARATION 20-0026 DPW 4/87 APPLICATION FOR :PLUMBI,NG PERMIT. i= ' I hereby, affirm fha{I have-d,certificate of consent fo self in.-',- •,76A667A sure,-or a certificate of Workers'•Compens`atioInsurance n ,'or'a• CE 817.(REV-8/86)•. certified_copy thereof'(Sec,3800,'Lob_ C-) , - =Policy°No 3� Cam pony COUNTY.OF LOS'ANGELES' - DEPT•. OF PUBLIC WORKS ; e' , L Certified copy is hereby furnished - _ `', " :" FOR'APPLICANT TO-FILL IN (PRINT OR TYPE) `- BUILDING, Ce}tified'ccpy is filed with the'county,building ir5speciion ADDRESS department - NUMBER FIXTURE'OR ITEM Ca FEE /� LOQALIT.Y Date t Applicant WATER,CLOSET(TOILET) OV f Q t r PP.cant ~ NEAREST, . ?- CROSS ST �ERTIFICATE OF EXEMPTION'FROM WORKERS', BATH-TUB-i,•. I W - VJ',(Q_ J COMPENSATION_INSURANCE = r1 r ,,OWNER SHOWER {,t409 (This section need not be completed if the.,work itni4olved byMAIL ` the'peimit is,for'one hundred dollars (5100)or less.) 5 r LAVATORY " ADDRESS y C v/ 'I c'ertrfy that in the performance'dfrthe work for which,this`per- mitais issued, I shall not employ any persdn in ny'manner'sq SINK• CITY T)> �Q EL' O 'r^ as•to-become subject to.the Wbrke?s' o sah DISHWASHER ` • is ?�` •t ,, _ .. ,�'; CONTRACTOR - • ' - , DatApplicant CLOTHES WASHER„ ` ` - ADDRESS 4 , N Tf TO A,PLICANT If;.afiermaking,ihis'Certificate of Ex-' :SWIMMING POOL'RECEPTOR ' emption, you should become.subject'to.the Workers;Compen- I' ' CITY TEL NO sahon„provisions of the Labor Code, you-must forthwith comp- < >• ' LAWN SPRINKLER SYSTEM ” )I`y�with.such provisions,or this permit shallwbe,deemed`,revok- STATE LIC_ .ed ' i,s WATER.HEATER' LICENSE NO 1 CLASS �.• si LICENSED.CONTRACTORS,DECLARATION, +-; DISTRIO PROCESSED BY ; GAS SYSTEM OUTLETS. (/Jj - I hereby affirm that I,am jicensedunder,pro visidns-of'Chapter _ 9(commencmg'wifh Section 7,000)of Divis(on 3 of the Busmess OUTLETS OVER and Professions Code, and my 14 ense'is in full force and ef- 5 PER SYSTEM' FINAL' / VA ATION > fect 4 _ DAT G �� d ' bcense'Number -' 'Lic'Clcdss C Contractor` ^ Date' FI - O r' I am exerript uhder Sec LJV B'8PC fonthisreason} FIgn,CheCk.fee" y ti Date " i; pop PLUMBING-PERMIT ISSUING'FEE $ '„e Signature= a• - - - ,�•0 9 a 0 A' -TOTAL-FEE #, = SINGLE FAMILY :oV'oJo o s 5 4HOMEIOWNER-BUILDER DECLARATION- Plan check appl cant- + } I'a`6'2a5,0 I hereby'affirm that 1'6m.exempt from the Contractors License. :' .Law for the'followi6g'recisow(Section 7031.5, Business and o,o~e =' Professions Code) t. t Address 2 B 5;0 J I, as owrier of '{he property,,'will=do"the'work and the C'tY 1' Te`I No s' t If'Q2 4;+e'$8 '•struct'ure is not intended or offered for sdle.(Sectwn 7044; a x - Busmess and Professions Code)" ' 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,�Gv ,C ) 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 comply with all County x, ordinances and State laws regulating Plumbing, and hereby f r( ^,~® w 4� authonze representdtrves of this'County'4o enter upon the, bb a-me tioned property for spection purposes t•_ _, ., ` o • ,- � - SEE,REVERSE.FOR:EXPLANATORY-LANGUAGE ig ature of Permittee D e y - - WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I;hecabv,pffirm that�,l.have a certificate of consent to self 76A667A insure, or a certifitate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab C//) 'W r COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No //7Q2Jt1 Companyn_ Jf2 `C &sT (u� Certified copy is hereby furnished - �- - - � --- FOR-APPLICANT-TO FILL IN(PRINT OR TYPE) BUILDING � � tion department Certified copy is filed with the county building inspec- ADDRESS NUMBER FIXTURE OR ITEM Q FEE LOCALITY p l� �yy � a � WATER CLOSET Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS 57 COMPENSATION INSURANCE SHOWER OWNER a2 Jho ' (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS v 0 l/( 4 V e P / I certify that in the performance of the work for which this permit is issued, I shall not employ any`person in any manner SINK CITY TEL NO y'_.4 so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR (2O AIAAJ ft- f)`� -Al C Date Applicant CLOTHES WASHER CADDRESS NOTICE TO APPLICANT If, after making this Certificate of (� Al r Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code,-you must forth- LAWN SPRINKLER SYSTEM CITY TIC* TEL NO with comply with such provisions or this permit shall be STATEy� LIC deemed revoked WATER HEATER LICENSE NO (A) 73 CLASS LICENSED CONTRACTORS DECLARATION DICT N_OESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS Vll(XJ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 911. and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL L� `v� DATE VALIDAT N 0 U License Number `6 23 � Lic Class CL FINAL O Contractor (/7 14"NI)l 41C Date "�� BY LU EJI am exempt under Sec � N B &P C for this reason Plan check fee � 1OR9A z Date PLUMBING PERMIT ISSUING FEE$ U # o o o 0 0 5 Signature TOTAL FEE ( - -.,l 6.5 0 Plan check applicant ' SINGLE FAMILY PP o o�0 16505 ' HOME OWNER-BUILDER DECLARATION Name 11.•1 9—8 4 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and Professions Code) City Tel No ❑ I, as owner of the property, will do the work and the structureis not intended or offered for sale (Section , 7044, Business and Professions Code) 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, Civ C ) 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 comply with all County ordinances and State jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 492, /i-/11?41r Signature of Permittee Date WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ♦ 20-0026 DPW 4/90 ,L-hereby, affirm that I have a certificate of consent to self in 76A667A sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Pol icy-No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building inspection ADDRESS department NUMBER FIXTURE OR ITEM Cal FEE LOCALITY WATER CLOSET(TOILET) /o Date Applicant NEAREST CERTIFICATE OF EXEMPTION'FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER / OWNER (This section need not be completed if the work involved by A111 MAIL the permit is for one hundred dollars ($100)or less.) , LAVATORY l ADDRESS I certify that in the performance of the work for,which this per- SINK CITY TEL NO mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER .ADDRESS NOTICE TO APPLICANT If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL NO sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC ed WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect HOSE BIB DATE License Number Lic Class V Va FINAL O _ /�/+ V Contractor Date BY ACC a G MI am exempt under Sec 331.13 750601- B 8P C for this reason Plan check fee 1 ITEMS 1L Date PLUMBING PERMIT ISSUING FEE$ a 7 3� TOTAL 75. 60Z Signature TOTAL FEE 10PId CASH 75.60 SINGLE FAMILY CHA%E a00 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 �OU'D001 11� 17q/ Professions Code) Address ' � � 310b 1 PM 5:�r6 j, 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) , 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, Civ C ) 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 comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned propal inspection purposes �B //- /- 7-7 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee lS Date