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Home My Public Portal About10228, 10224 DAINES DR_Plumbing__ 76 A 667 -•CE 817 7-69 Ir •' __'G'_�� _ APPLICATION FOR PLUMBING PERMIT , ` ,., COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER. BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN VV JENKINS. SUP T OF BUILDING LOCAL FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST CROSS ST. NUMBER -FIXTURE OR ITEM EACH FEE - f _ f OWNER WATER CLOSET 1.50 * MAIL . BATH TUB 1.50 ADDRES r , SHOWER - 1.50 CITY TEL LA V AT OR Y 1 5 0 CONTRACTO - SINK 1.50 D •ADDRESS ' DISHWASHER 1 50 CITY TEL. NO. 773 CLOTHES WASHER 1.50 �D STATE LIC LICENSE NO d CLASS SWIMMING POOL RECEPTOR 1 50 DISTRICT N GTP ZO E P D BY LAWN SPRINKLER SYSTEM, 2.00 / WATER HEATER' 1 50 INDUSTRIAL WASTE APPROVAL Q GAS SYSTEM ,OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER• 5 PER SYSTEM' ' _ 30 H Z Plan check fee 25% of above. See reverse PLUMBING PERMIT ISSUING FEE $ 2 100 TOTAL FEE, . APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK' Name ,ROUGH PLUMBING - Address GAS PIPING' GAS VENT City � Tel ''No. - HOT WATER HEATER 12=70 �r�w I`HEREBY ACKNOWLEDGE THAT 1 HAVE' READ THIS APPLICATION AND STATE THAT THE••ABOVE 19 CORRECT AND AGREE TO COMPLY PLUM BINGM FIXTURES WITH ALL COUNTY ORDINANCE. AND STATE LAWS REGULATING GAS TEST PLUMBING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY-CO NOTIFIED LICENSED eAS REQUIRED BY LOS ANGE ES COU AND STATE OF CALIFORNIA OR'THAT 1 AM THE LEGAL WN OF,`AND INTEND TO• RESIDE IN,THE ABOVE DE D REGI NT PR I Y G �. FINAL7O SIGNATURE -.TACK R. ALLEN, SUPERVISING MECHANICAL OF PERMITTEE PERMIT VALIDATION CK M o CASH PLAN CHECK VALIDAT cK o CASH is_,'6. rus 5...0 76Aee7 17 9-49 ® 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 � 8./�Cfl./`^-� RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS �/ C� V �/�V'�� j BUILDING �/ -/ _0e Ir SS SS QADORE CITY NOCOUNTY TY LICENSE NO EXPIRES 0 S WJn,a^rW-�_l�w✓)� (f LOCAL NEAREST ,L PERMIT FEES CROSS ST V NUMBER I TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) Q 050 I$ ADDRESS TyA,✓�D �w� BATH TUB Q O 50 CITY ✓�4 �II+�R TEL NO. SHOWER Q O 501 1 —� I HEREBY ACKNOWLEDG THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) tQ O SO I� APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK Q O 50 I� STATE LAWS REGULATING PLUMBING Q ABOVE VALID LOS LAUNDRY TUB OR TRAY O 50 1 I CERTIFY THAT I POSSESS THE ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER GAS SYSTEM---3—OUTLETS O 50 I OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. Q SIGNATURE OF WATER HEATER Q O 50 I PERMITTEE �a�_� it-� SLOP SINK Q O 501 INSPECTION RECORD FLOOR SINK Q O SO l I— FLOOR DRAIN Q O 50 1 1 IDISHWASHER Q 0 501 _ I DRINKING FOUNTAIN Q O 50_1 URINAL Q O 501 .J 1 HOUSE SEWER Q O Sol I Z MISCELLANEOUS I� APPROVALS DATE INSPECTOR'S NAME II I ROUGH PLUMBING GAS PIPING 1 1 I GAS VENT CESSPOOL Q 1 00 1 I CESSPOOL SEPTIC TANK- I I £EPTIC TANK I DRAIN ( ) PIT ( ) Q 1 001 I SEWER PERMIT . I 1 00 GAS TEST I �, ` •' UTILITY CO NOTIFIED FINAL I TOTAL FEE I O-7) �-I A� 76AS67 17 5-49 ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING I WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRINO. GROUP ZONE �®R IT� ' PLUMBER _ eAAA ��HCEIVED BY READY FOR DATE ISSUED zw O I FIRST INSPECTION 7,`7-<521 ADDRESS BUI DING CITY A TEL. NO. ADDRESS COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. j}�r NUMBER TYPE OF FIXTURE OR ITEM FEE - OW ER MAIL WATER CLOSET (TOILET) ® 0.50 s ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY.-LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE- GAS SYSTEM OUTLETS @ 0.50 ' SIGNATURE OP `) } WATER HEATER @ 0.50 PERMI TTE - -�� SLOP SINK @ O so INSPECTION RECORD FLOOR SINK @ O 50 FLOOR DRAIN @ O 50 DISHWASHER @ O 50 DRINKING FOUNTAIN @ 0.50 URINAL @ O 50 „J HOUSESEWER @ O 50 a Z MISCELLANEOUS It O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1 00 CESSPOOL SEPTIC TANK. SEPTIC TANK ° DRAIN ( ) PIT ( @ 1 00 SEWER PERMIT 1.00 GAS TEST UTILITY CO. NOTIFIED �•�,• s I TOTAL FEE I $ ✓^ '> �' ��^' �'C>60F FINAL �f WORKERS' COMPENSATION DECLARATION . ,,APPLICATION FOR 'PLUIIABING PERMIT 20-0026 /87. T'h'ereby;affirm that I have,a-certificate of consent to self 76A667A DPW 4 sure,ora; �certificate of-Workers'Compensation Insurance,"or a CE•817(REV 8/86)' 'certified copy,thereof (Sec ,3800, Lab-C•) " Poltc",No `"' F' ` ,, COUNTY`OF LOS ANGELES DEPT. OF.,PUBLIC, WORKS Yt Company 5 E! Certded'copy is`hereby furnished .t• -+ FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified`copy is filed wrth'the courity'building_inspection - ADDRESS q :depdrimeni - `NUMBER FIXTURE,OR,ITEM Ca FEE { LOCALITY Date v4 A licant; - ; � 'WATER CLOSET(TOILET) _ 4. .. PP ,_ a :NEAREST ;e CERTIFICATE OF EXEMPTION.FROM WORKERS'` BAiH TUB CROSS ST COMPENSATION INSURANCE. ;%`- ¢ OWNER •5 -C� �0 "-, I r SHOWER Jt (This `section need mot.be completed,if the work involved by _ the°permit is^for orie'hundre'd dollars ($100)or less.)., LAVATORY SIL' ' ADDRESS ,I certify that m the performance of the,work'fof which this per- • ti mit is issued, I'sholl n"ot,em to -an SINK' CITY TEL, NO p y 'y personrm'ony`man`ner.so .'• .� -, •S ys'to become`sublect to 1he�Workers'•6ompensation'Laws _ r , �. DISHWASHER,' + d _>- CONTRACTOR' Date r• a•Applicanii' =` CLOTHES_WASHER�" ADDRESS r• � NOTICE TO APPLICANT rf,'after mak'ing'.this Certif cote of Ex- rr phon,'you'sh' uld become subject'to'ihe_Woikers'Compen- SWIMMING POOL,,RECEP,TOR - ' sation rovissons of the'L'abor`Code, ',ou must forthwith com CITY TEL NO p y P LAWN SPRINKLER SYSTEM ly,with such provisions'or•this perm'it.shall-be'd'eemed•revok- STATE ;LIC �,ed = ,; ° WATER_HEATER r p LICENSE,NO a 'CLASS ° ` ;' '•• LICENSED-CONTRACTORS DECLARATION" ' DISTRI P OCESSE Y, I hereby affirm that I am.licensed underprovisions of Chapter GAS SYSTEM` y ' OUTLETS a - - 9,(commencing•with-Sectt;n'7000)of'Dtvtston 3 of'the Business OUTLETS OVER and Professions Code, and my license is,m'full force and ef- 5'PER SYSTEM r FINAL- �/, ALID TION,",. a fect _ ll .• :'DATE O License Number Ltc' Class FINAL { Contractor D"ate _ BY ,. -O I axempt ynder-Sec ,° W m e B &P-C-for iliis reason, ti ° y r Plan check.,fee',: - 'Date-1 PLUMBING PERMIT ISSUING FEE' $ a Signature t •: •�.� . } ', TOTAL FEE SINGLE'FAMILY 'r r 'HOME OWNER,-BUILDER DECLARATION , Plan check applicant,, a I hereby affiPm.th' t I am exempt from`the'Contracior's License Name - Law for`the"following reason (Section'7031'5, Business"and 'Professions Code) ,'• - Address iy4c•Tos' • ' as 3397 '- dwner"of the"property, will do the-work and the City ) Tel No' n" t - structure is not'intended or offered;forsale,(Section 7044', �n, _ y ITEME: + a fl Bustriess'and Profes'sioins Code)' "' ' '7 ' CONSTRUCTION LENDING AGENCY• _ .� . r ,r �,TOTAL 4,3 00 e` I'Fier'ekiy afficmah&trthere is,a'construction lendmgiagency for a i " �:: r=HE •��' .ihe'performance,af^the work-'for which-ihis'permrt is issued, tF, t•'• -CHANGE, CO(Sec 3097, Gv'C ) o Lend'ef's Name u tF 5� --Y r f _. Arts, �30 Lender's•Address t, a` 9016' I certify that,I'Piave•read this,applicat`ion'and state-that the, +-- :i� '�- '' q r above information is'correct'I agree to comply with aIl.County '= ordinances and State,�laws'regulatIng Plumbing, and hereby _` •� tau , ' representatt'ves of.thus County to.enter'upon t`Re' a e m oned operiy f As eUion pulposes f es' t'SEE REVERSE FOR EXPLANATORY LANGUAGE•,., Y gndture of Permittee Date