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HomeMy Public PortalAbout5124 DALEVIEW AVE_Plumbing__ 76A667 -CERBIT 12-66 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONNGINEER ADBUILDING C � JOHN A. LAMBIE. COUNTY EDRESS 5I2. TVALE kew COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY 't ErLkQLe ClT FOR APPLICANi TO FILL IN NEAREST GROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 81.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 125 CITY SEL. NO. LAVATORY 1.25 CONTRACTOR L 1 EN OD SINE 1.25 ADDRESS 1 LLC ..11 DISHWASHER 1.25 CITY L_V TEL. HOED O'1CTOR'S STATE Y�� LAUNDRY TUB 1.25 REGINBTRATRAT ON NO. Z..31�1 COUNTY CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PR09jESSED BY WATER HEATER 1.50 1 _ J Z GAS SYSTEM OUTLETS 1.50 INDUSTRIAL Y WASTE APPROVAL d OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD Do ` F c 0 W - a (A Z t' APPROVALS QATIE, INSPECTOR'S SIGNAII PERMIT S 2 00 UNDER SLAB WORK P)•( ROUGH PLUMBING I.TOTAL FEE GAS PIPING I 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 PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO RESIDE IN, THE ABOVE DESCRIBRIG RESIDENTIAL pPROPERTY. UTILITY CO. NOTIFIED SIGNATURE C /' �J OF PERMITTEEFINlid' 1111A� _ M AL VALIDATION ROBERT A. WOOD cK. M.D. CASH SUPERVISING MECHANICAL ENG'R i AC , 5 2 6 00 SEP 3 5 D 5.00- 1 ')e AeM1:•A (Ce BVBI -4/17 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION - A/ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING - A NUMBER FIXTUREORITEM ® FEE ADDRESS15 WATER CLOSET LOCALITY BATHTUB NEAREST n CROSS ST. Jti�it a�.-R SHOWER OWNER 6,os4 AAL /f" EG�i4L LAVATORY MAIL ADDRESS tF- SINK CITY TEL.NO.�s� DISHWASHER CONTRACTORAIJrft) , (:Z 6ve 6y CLOTHES WASHER �l ADDRESS 3�I.V �, `1/ SWIMMING POOL RECEPTOR CITY /)-I TEL.NO. XL3 J 671 LAWN SPRINKLER SYSTEM — STATE �] WATER HEATER LICENSE NO � CASSC -Cd 6 GAS SYSTEM OUTLETS O D1513ICTT NO.Of R SSED BY Y OUTLETS OVER O 5 PER SYSTEM INDUSTRIAL t..) WASTE APPROVAL INSPECTION RECORD U W 1 N Z Plan check fee .� PLUMBING PERMIT ISSUING FEE$ A �0 TOTAL FEE 4i o0 Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Nome UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GASVENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PE RMITTE FINAL O O O %.I e O PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION I• SZ) S tK. a 111 CASH -7 O O o cD OD o o cn a CH 76A661-CE+517 6-65 APPLICATION FOR PLUMBIN PERMIT COUNTY OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEER ti BUILDING AND SAFETY DIVISION BUILDING f JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS a / COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 71.25 MAILL BATH TUB 1.25 ADD Ss 5 C SHOWER 1.25 CITY EL. NO. LAVATORY 1.25 CONTRACTOR SINE 1.25 ADDRESS L!/ DISHWASHER 1.25 CITY STATE LAUNDRY TUB 1.25 LICENSE NO. CLASq CLOTHES WASHER 1.25 DISTRICT NO/1/ G NE BY WATER HEATER 1.50 t l/J1 Ol/ 2. Y GAS SYSTEM OUTLETS 1'50 INDUSTRIAL a WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD V s O U w 1 h z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 5S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE 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 PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES LICENSEDAS 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 RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED I SIGNATURE OF PERMITTEE 1 FINAL VAI N M.0. � CK. M.0. `( C✓ASH/ w L1LO 9 9 9 2'1 FEB 2 4 5 0 5.00,- Q 76A667A ICE 61 7131- 11/76 1 / �� APPLICATION F RP UMBIIVC PERMIT ' READY ruRl. Ff ,IAL [ � Q� I BUILDING AND SAFETY DIVISIO FOR APPLICANT TO FILL IN PRINT OR TYPEI BUILDING A � ` ep NUMBER FIXTURE OR ITEM O FEE ADDRESS, ` l_V J kl WATER CLOSET LOCALITY :]�trf-NPC (.�I T NEAREST _ - �' BATHTUB NEAREST < I�/ �"F SHOWER OWNER .LAVATORY MAIL �t ADDRESS SINK, CITY TEL.NO. DISHWASHER CON MAIFIC STALLERS CLOTHES WASHER - ADD E. GRAND . VF SWIMMING POOL RECEPTOR CITY EM''P77L/E Cl/yTY T G �2— 0 LAWN SPRINKLER SYSTEM STATE LICENSE NO{1�( L 1 LIC. WATER HEATER CLASS GAS SYSTEM OUTLETS DISTRICT NOQ. GROUP ZONE P OOCCESSERBY OUTLETSOVER DU R V/-rl C 5 PER SYSTEM INDUSTRIAL • _ d WASTE APPROVAL- C INSPECTION RECORD U O HHV W d N Z Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL PEE • Plan check applicant Name APPROVALS 'DATE INSPECTOR 5 SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ TH15 APPLICATION AND STATE GAS VENT ' TNAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES -AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTEREDAND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE BE5CRIBED RESIDENTIAL PROPERTY. /� UTILITY CO NOTIFIED SIGNATURE / 1 I � . ( '.^/T - OFPERIT MTEE /L FINAL PLAI�I�jeC1@AACTDA-DON* rcn Myo. ensH, PERMIT VACIDATI�N' cK` cns®ya . .. . , a COiVdPEN19A.T00N 1 2 1r,JAN 1 i `7,5 i.1 POLICY HOLDEI'. Os POLICY NUMBER: x,©996 A Q� pp FOR lolpl 1�1 pppppL1ll�� l�ipp I�ll��l�p{� _ '•YORKERS'COMPENSATION DECLARATION APPLICATION FOR PLL7.1'AtlBIDONG PERMIT A inl khat I have a certificate of consent to self 76A,567A - n. ceStificate of Workers'Compensation Insurance, .CE 617(REV. 10/81) V.,a cert tie copy thereof (Sec.��3800, Lab. C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY' Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR,TYPE) BUILDING £'IZE� �NLEVIEs� /'T �� ' Certified copy is filed with the county building inspec- ADDRESS J tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Appliqant - WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. C?RA"hJ l7 'COMPENSATION INSURANCE OWNER SHOWER Wigil mg fil/3TSt�.r7it .(This section need not be completed if the work IavolVed.by _ ••���'�' I r� MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS .:J ! Z`•� (//rL ✓/Si.J n�� I certify that in the performance of the work for which this permit is'issued, I'shall not employ any person in any'.manner SINK CITY TEL. NO. T�int'F e- TEL. �%�/�o3y9 so as to become subject to the Workers'Compensation Laws. DISHWASHER. Jy� si�s'✓1 - CONTRACTOR Date f � �V Applicant xANti� ���' � CLOTHES WASHER NOTICE TO A PLICANT: If,' atter ma ing this Certificate of ADDRESS Exemption, you should become subject to the Workers SWIMMING POOL RECEPTOR — Compensation provisions of the Labor Code,,you must forth- 'CITY TEL NO. LAWN SPRINKLER SYSTEM with comply with such provisions-or this permit shall be STATE - - `LIC deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT`O.-�. R ESSED.BY I hereby affirm that I am licensed under provisions of Chapter 9 .GAS SYSTEM OUTLETS 409 [� V�1 (commencing with Section 7000).of Division 3 of the BusinessOUTLETS OVER J and Professions Code,and my license is in full force and effect. 5 PER SYSTEM 6 . FINAL V DATE - ALI TION u License Number Lit. Class pp FINAL O Contractor Date BY - y ❑ W. am exempt under Sec H B.BP.C. for IT is reasonZ - Plan check fee Leo !O PLUMBING PERMIT ISSUING FEE$ J SignatureJ/ TOTAL FEE o �9 3 4 1 .1 A Plan check applicant # • • is e • 5 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name .( e e 1 650 hereby affirm that I am exempt from the Controctoi S,License gddress _ Law for the fallowing reason (Section 7031.5, Business and y a a.� (a 5,0�Q Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the 01,2 4-S 6 , structure is not intended or offered for sale (Section 7044, Business and Professions_Code). - CONSTRUCTION LENDING AGENCY I hereby offirm 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 _ ordi antes and State lows regulating Plumbing, and hereby - out c{ri ze representatives of this County to enter upon the - r a ve-men bone property for inspe tion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ture of Percm ltee