HomeMy Public PortalAbout9662 CRAIGLEE ST_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY j�
WILLIAM J. FOX, County Engineer
DISTRICT N.O. GROUP I YON .
FOR APPLICANT TO FILL IN
10 6-' . 1 'k— / 5S 17
PLUMBER RE EIV E READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS zapr
BUILDING �� ✓
CITY TEL NO U'r ADDRESS
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COUNTY 2. ' LOCALITY
LICENSE NO. EXPIRES !��® J�3
NEAREST
PERMIT FEES cRDss ST. O_ _
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) O.SO $ ADDRESS___
BATH TUB 0.50 O CITY v TEL. NO.
SHOWER (d4 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 0 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK Q 0.50 AND STATE LAWS REGUL�AT/ G PLUMBING.
PO I CERTIFY THAT I�.PDS9ESB THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICE R 1 AM THE LEGAL OW R
GAS SYSTEM—_OUTLETS 0.50 OF THE RESIDENT L P P ML DEB
ABOVE
v.
SIGNATURE OF
WATER HEATER @ 0.50 PERMITTE
SLOP SINK @ 0.50 SPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN CC 0.50 -
DISHWASHER @ 0.50
DRINKING FOUNTAIN 0 0.50
URINAL 0 0.50 - J
HOUSE SEWER 0 0.50 Z
MISCELLANEOUS �,_,�,}�� L7
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING �(a (�4u
GAS PIPING ^�-`-- t�[����
GAS VENT 0 2-p ( "y--a 111A
CESSPOOL @ 7;00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) Cts 1.00 SEWER
PERMIT t.oD OAS TEST
UTILITY CO.NOTIFIED
TOTAL FEE $ 00 1
FINAL
7GA667 DBS#17 6-52
76A667C (CE-817B) -9/75
APPLICATION FOR PLUMBING PERMIT
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BUILDING AND FETY DIVISIOn G E.
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FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDADDRESS 9662 ,E. CRAIGLEE
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY
TEMPT E MY
NEAREST a'
BATH TUB CROSS ST
SHOWER OWNER
LAVATORY MAIL 111�LL�
ADDRESS
SINK CITY 'F' TEL. N- CITY
O.
DISHWASHER CONTRACTOR
CLOTHES WASHER MAM TIM
ADDRESS 2034 N. PECK. RD
SWIMMING POOL RECEPTOR
CITYTEL. NO. 579-7982
LAWN SPRINKLER SYSTEM r�
STATE
WATER HEATER LICENSE NO. 265094 CI ASS C-20
a
DISTRICT NO. GROUP �g{�E PR ESS 8CD
1 GAS SYSTEM JOUTLETS 3 00 I I/n /( a
OUTLETS OVER G IY�7`Y O
5 PER SYSTEMINDUV
STRIAL
WASTE APPROVAL W
a.
INSPECTION RECORD to .
Plan check fee
PLUMBING PERMIT ISSUING FEE $ 0
TOTAL FEE 7 50
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
ACICIfeSS ROUGH PLUMBING
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS.APPLICATION GAS VENT
AND STATE THAT THE ABOVE 15
CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES `
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST -/
CALIFORNIC�?A OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RES ENT PR PERTY. UTILITY CO. NOTIFIED
SIGNATU RE
OF PERMITTEE INAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION Kms M. CASH
6.5.?"N;APR 13 5 0, p e;
,,j� WOf :ERi' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
' lfic��by�a'ffirm that I have a certificate,of corisent to self in- 20-0026 DPW 4/87 n
sure, or a cerlificate of.Workers'Com ensation Insurance,or a CE 817 A �1 I
P CE 817(REV 8/86) - U ,
certified copy thereof (Sec. 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
Certified copy is filed with the county building inspection ADDRESS
department. NUMBER FIXTURE.OR ITEM @ FEE LOCALITY
Date Applicant WATER CLOSET(TOILET) �— NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' R _2
BATH TUB CROSS ST. - +
COMPENSATION INSURANCE SHOWEROWNER, �
(This section need not be completed if the work involved by MAIL
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS
I certify that in the performance of the work for which this per- SINK
mit is issued, I shall not employ any person in any manner so Z — CITY TEL. N�
as to become subject to the Workers' Compensation Laws. DISHWASHER
CONTRACTOR
Date Applicant CLOTHES WASHER
ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
emptionp
, you should become subject to the Workers'Comen- SWIMMING POOL-RECEPTOR
CITY TEL. NO,
sation provisions of the,Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM.
ly with such provisions or this permit shall-be deemed revok- STATE LIC.
ed. WATER HEATERLICENSE NO. CLASS
LICENSED CONTRACTORS DECLARATION /GAS SYSTEM OUTLETS DISTRICT NO. PR ESSED BY
I hereby affirm that I am licensed under provisions of Chapter '� �'�1 1
9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O/
and Professions Code, and my license is-in full force and ef- 5 PER SYSTEM FINAL/2VALIDATION >_
fect. DATEIL
License Number Lic. Class O
' FINA U
0
Contractor Date BY 0
I am exempt under Sec. UJ
V
B.&P.C. for this reason
Plan check fee
Date: PLUMBING PERMIT ISSUING FEE$
Signature TOTAL FEE
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Plan check applicant
I hereby affirm that l am exempt from the Contractor's License Name
Law for the following reason (Section 7031.5,-Business and
Professions Code): Address 5_1
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, EN
Business and Professions Code). ► s 50.
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
F €}I
(Sec. 3097, Civ. C.).
n= -
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
abonti�propjerty for inspection purposes.
0
`t f�.�9 SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee D