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Home My Public Portal About9979 DUFFY ST_Plumbing_05/23/1966 76A667-CE#81 7 6-65 r r 5`)r08 <P u F F M a APPLICATION FOR PLUMBING 9ERM.17 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER 'ADDRESS �9�� OF F COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER C� _p p lv WATER CLOSET $1.25 MAIL Q BATH TUB 1.25 Ll ADDRESS �� ) !/lJ CITYjr (jL TEL NO. S SHOWER 1.25 LAVATORY 1.25 CONTRACTOR SINK 1.25 ADDRESS �Qer-Q C_'SZP. Ql> DISHWASHER 1.25 CITY'r(;, c, I (�-_IT TEL. NO.q-jZ-_-)p"_)Q SATE LAUNDRY TUB 1.25 LICENSE NO. ? ) /lJ CLASS o CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1'� INDUSTRIAL O WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V 0 V W a. N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 L UNDER SLAB WORK O ROUGH PLUMBING TOTAL FEE r GAS PIPING 0 I HEREBY ACKNOWLEDGE THAT 1HAVE 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 REGISTER AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND TE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INT D TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATURE I OF PERMITTEE FINAL ALIDATION CK M.O. CASH rio 2 'JaAY 2 3 5 0 3.50 D.B.S.-17 25M SETS 12-45 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES D Wm. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATIONDISTRICT NO. GROUP ZONE �/PERMIT NO. ROUGH FIXTURES COMPLETE RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK 1.- FIRST INSPECTION y GAS MISCELLANEOUS APPLICANT PILL IN HEAVILY OUTLINED PORTION ONLY E NAME '^-'• s. -;i ?--� ;� JOB ADDRESS ADDRESS �.. •',, sL_i-ti`��'�+"' LOCALITY d'�,�bSG-�•;'�il- (� r -1 CITY 2v2` :.t'ri E�'i`-'T•EL.Nb`�E. CROBSBT. CJ9fi- �. •vf"l COUNTY C V1 CI i'Y: r`A 1_p. I i NAME !__., ► CERT.No. E](P'iR�,.e LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL ADDRESS NORTH O CITY TEL. NO. I AM THE LEGAL POSSESSOR OF THE ABOVE LOB ANGELES COUNTY CERTIFIC E OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBRD ABOVE. ' D 0 OWNER CORRECTIONS SOUTH DESCRIPTION OF WORK � BATH TUB FURNACE sr SHOWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN BINK WATER SOFTENER FLOOR SINK SAND TRAe n SLOP SINK FLOOR DRAIN WASH TRAY URINAL v� APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER 0 GAS SODA FOUNTAIN OUTL GAS'PIPING GAS VENT la -zom CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI SEPTIC TANK ./ V V SEWER UTILITY CO.NOTIFIED I TOTAL FEE , (� I FINAL TGA667 17 s-Iso It APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES. LUMBONG I WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRIC NO. GROUP ZONE PERMIT NO. B �@J PLUMBEF, , .�, - RECEIVED BY READY FOR DATE ISSUED -,2 ey - ion erTc ey flark,Cai(f. /7 FIRST INSPECTION / ADDRESS�ZR-itiET"ro51, C-U^ Berland Q-1040 AI BUILDING CITY TEL. TEL. NO. 9 ` ADDRESS COUNTYLICENSE NO. / v 6l EXPIRES 0 30 LOCALITY' I I I NEAREST PERMIT FEES cRoss ST. • #� NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER �I MAIL WATER CLOSET (TOILET) @ 0.50 s ADDRESS m �J BATH TUB @ 0.50 1 I -o OITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS CLfj I LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. KITCHEN SINK @ O.50 �� 1 CERTIFY THAT I POSSESS' THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LIC OF THE RESIDENT L P -,'BERT ��j11 THE I OVE. OWNER GAS SYSTEM—A–OUTLETS @ O.50 I �� plill, WATER HEATER @ 0.50 1 SIGNATURE OF V PERMITTEE SLOP SINK INSPECTION RECORD FLOOR SINK @ O.SO FLOOR DRAIN @ 0.501 DISHWASHER @ 0.501 DRINKING FOUNTAIN @ 0.501 URINAL @ 0.501 1 _ HOUSE SEWER @ 0.50 1 I Q MISCELLANEOUS 1 U' I Q.' 1 1 O I� APPROVALS DATE INSPECTOR'S NAME 1 ROUGH PLUMBING GAS PIPING GAS VENT G✓f CESSPOOL ti) 1.00 I CESSPOOL SEPTIC TANK: I 1 .SEPTIC TANK I DRAIN ( ) PIT ( ) @ 1.001 I SEWER f PERMITr I ►.00 GAS TEST • UTILITY CO. NOTIFIED 1 ,0() TOTAL FEE FINAL Y WORKERS' COMPENSATION DECLARATION o 0 N FOR Io 0 0 0 I hereky affirm that I have a certificate of consent to self 76A667A ��OBCI Il OO 110 ll �vUV11UUl1V� u LSUUI1Gll� Il insure, or'a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified 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 I/� Certified copy is filed with the county building inspec- ADDRESS '`—'\tion depart ent. � NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date /l Applicant WATER CLOSET NEAREST 609 CERTI ICATE OF EXEMPTION FRO WORKERS' BATH TUB CROSS ST. ea 12 COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL O ADDRESS I certify that in the performance of the work for which this permit is.issued, I shall not employ any person in any manner SINK r CITY /* TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER q n� �, CONTRACTOR Date�� U" plicant IL�}i//��P(�lr(y - CLOTHES WASHER ADDRESS O NOTICE TO APPLICANT: If, after, making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY s TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM �r with comply with such provisions or this permit, shall be STATE O LIC !� deemed revoked. WATER HEATER LICENSE NO. SS LICENSED CONTRACTORS DECLARATION DISTRICT N . PR CESSED BY 1 hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS d " (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL . bALIDATION � �� DATE / JELI License Number��/�J�2L( `rR Lic. Clas � Q FIN Contractor U. Contractor ate 4:�_p �, B ❑ I am-exempt under Sec. 0 U B.BP.C. for this reason W Plan check fee Dn: 047 D Cn Signature 'lePLUMBING PERMIT ISSUING FEE$ Z • ' TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 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 structure is not intended or offered for sale (Section D 2599.7 A 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY # 0 0 0 0 0 5 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued 0+ 0.1 5 0 . (Sec. 3097, Civ. C.). _ � o.- 16,5.0� Lender's Name 1 1.20"86 Lender's Address I certify that I have read this application and state that the D 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- entionWpopy for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ature o P tee D to