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Home My Public Portal About4843 EL MONTE AVE_Plumbing__ 76A667-CEP817 6-65 APPLICATION FOR PLUMBI G PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION rADDRESS DING j/�J T [/ /I f �/ /1� � [�U� JOHN A. LAMBIE, COUNTY ENGINEER 4 jy ✓ / i" /! COLEMAN W. JENKINS, SUPT. OF BUILDING ALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM_ EACH FEE OWNER l5er4 6�v. WATER CLOSET $1.25 j`D MAIL7t / 7 BATH TUB 1.25 ADDRESS C_/ 6410 � SHOWER 1.25 CITY TEL. NO. Z LAVATORY 1.25 S`�j CONTRACTOR SINK 1.25 1 z�^ ADDRESS /1l' S Lo ha4,a, /,z P DISHWASHER 1.25 CITY ( FSc'llGiC TEL. NO. �Q5Vj/ STATE LAUNDRY TUB 1.25 LICENSE NO. LIC �j/� �� CLASS C CLOTHES WASHER ' 1.25 / Z.S DISTRICT NO GROUP ZONE WATER HEATER 1.50 l GAS SYSTEM OUTLETS 1.50 5 U INDUSTRIAL } CL WAST£ APPROVAL O OUTLETS OVER 5 PER SYSTEM .30 5 INSPECTION RECORD V O E- U W d N Z APPROVALS DATE INSPEC R'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK T/ ROUGH PLUMBING TOTAL FEE 1 5 GAS PIPING 1 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 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 RESIDEZIAROPERT V. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE / ' FINAL / CK.C� ID ALATION M.O. CASH Lo ' 9 JUN 2 2 5 a 1 3.7 5— �F 7W,f.: CE 817 468 h,'W� +p I� �! APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS _ JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY 'rte FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE /�. WATER CLOSET 1.50 OWNER MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTOR SINK 1.50 ADDRESS �� ^�. I /? .. DISHWASHER 1.50 CITY 7 ' TEL. NO. CLOTHES WASHER 1.50 STATE ,�( LIC LICENSE NO::y y 'f CLASS e'-36 SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PROCESSED BY LAWN SPRINKLER SYSTEM 2.00 /'f? WATER HEATER 1.50 INDUSTRIAL V WASTE APPROVAL Z GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD 0�,,,, OUTLETS OVER 1.� 5 PER SYST M •30 Lu W AAR Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE $ 00,/ 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 IHEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY ANGELES UN�Y AND STATE OF CALIFORNIA OR THAT 1 TH LEGAL WNER F.AND INTEND TO RESIDE IN,THE ABOVE DFSCR D RESID ,� ROPegm. FINAL l� SIGNATURE JACK R. ALLEN, SU PERVISI G ME NI AL EN- 'R. OF PERMITTEE PERMIT VALIDATION C o ASH PLAN CHECK VALIDATION CK. M. CASH Cq u 11,0 7, 4 7 NOV 2 4 :- D 6.50- � i 1 WORKER'S COMPENSATION DECLARATION 76A667A 6DPW9/89 APPLICATION FOR PLUMBING PERMIT 76A66 ;I hereby affirm that I have a certificate of consent to self insure, •- ,or a certificate of Worker's Compensation Insurance; or a certified rropy thereof(Sec. 3800 Lab.C.) Policy lvo.�� Z�'Company �G� G� Cr COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Certified copy is hereby furnished. f FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGADDRESSf t� Certified cop is filed with the county building inspection e artmen NUMBER FIXTURE OR ITEM @ FEE LOCALITY Da Appliga r � WATER CLOSET NEAREST j CERTIFICATE OF EXEMPTION FROM WORKERS' CROS VL �� i BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK E PARCEL permit is for one hundred dollars($100)or less.) OWNER certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as to SINK MAIL ADDRESS become subject to the Workers'Compensation Laws. i DISWASHER CITY L.NO. (Date Applicant CLOTHES WASHER rll NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR ,�� A Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR t� provisions of the Labor Code, you must forthwith comply with such ADDRESS `provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM ' LICENSED CONTRACTORS DECLARATION CITY EL. � �- I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE LIC. Q. (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO � CLASS Z V Professions Code,and my license is in full force and effect. ' OUTLETS OVER DISTRICT NO. PROCESSED BY cc � 5 PER SYSTEM QV(License Numb�� oLic.Class C� FINAL / �_� DATE VALIDATION IIW. Cont D T _ FINAL 'at' 3a 3• Z I am exempt under ec. BY J B.&P.C.for this reason Plan check fee , Date: Signature PLUMBING PERMIT ISSUING FEE$ AL. 4 _ 85 �j TOTAL FEE / d i:H i;?:, d 1.;2.5 Plan check applicant Fs(_ ,i 1_3 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name hereby affirm that I am exempt from the Contractor's License Law or the following reason (Section 7031.5, Business and Professions Address j= ;Ik—j_+ji_i :,{jj•i;`iJ; Docile): City Tel.No. 10 I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). ' CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the ,)erformance of the work for which this permit is issued (Sec. 3097, "iv.C.) Lender's Name ender's Address in certify that I have read this application and state that the aboveformation 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 thea ove-mentioned property for inspection purpose SEE REVERSE FOR EXPLANATORY LANGUAGE gna ure Of Permittee Dale