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Home My Public Portal About4917 ENCINITA AVE_Plumbing__ 76A667-CE817 1259 TEMPLE CIT V APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESSTTT� WILLIAM A. JENSEN, SUP'T OF BUILDING LOCALITY - 7 y FOR APPLICANT TO FILL IN NEAREST EA SSTT. NUMBER FIXTURE OR ITEM OWNER KG C!L i G WATER CLOSET MAIL / ADDRESS BATH TUB CITY TEL. NO. 7e- SHOWER LAVATORY CONTRACTOR SINE ADDRESS DISHWASHER CITY TEL. NO. CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY ❑ CLOTHES WASHER DISTRICT NO. GROUP ZONE ROCESS BY WATER HEATER S 4 '7-- GAS GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD w 0 U a O H U W P, VI z ca $1.00 PER ITEM 19 OR FIXTURE APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S Z 00 UNDER SLAB WORK TOTAL FEE /q`V ROUGH PLUMBING ' � 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 PLUMBING. HOT WATER HEATER 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 THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATURE ' OF PERMITTEED FINAL ®F VALIDATIO ROBERT A. WOOD, CK. M.0. tl CASH SUPERVISING MECHANICAL ENG'R D B S 17 25M SETS 7-47 APPLICATION FOR PERMIT' -c� IDIEPARTMEN`t` OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES Wm J. FOX,CHIEF ENGINEER NATURE OF INSTALLATION DISTRICTNO GROUPIZONEPERMIT No. ROUGH FIXTURES COMPLETE HEATER CESSPOOL -I SEPTIC TANK C�IVED BY READY POR DATE ISSUED 1_ FIRST INSPECTION ^ Cj A9 MISCELLA SOUS APPLICANT FILL IN HEAVILY OUTLINED`PORTION ONLY /]� NAME JOB ADDRESS ADDRESS L/! LOCALITY 7 011.5 , IL CITY _ TEL No. G p5� CROSS ST.11460 X R -e s .,o- CERT.No EXPIRES A 6 NAME ;1? 7 V1 /)L 21 LOCATION OF SEPTIC TANK, OR CASSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL No. 1 AM THE LEGALPOSESSO OF THE ASO-YE LOS ANGELES COUNTY CERTIF�E gUACtFICAT ON. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORD a z_ BATH TUB FURNACE [7 SHOWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR B NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING IMETER___J_GAS ------SODA FOUNTAIN GAS PIPING OUTL _ GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CE88POOI +QEPTICTANK SEWER � UTILITY CO NOTIFIBD TOTAL FEE FINAL D B S-17 25M SETS 12-45 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY { COUNTY OF LOS ANGELES P L ll B I N G ' Wm J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT NO ROUGH FIXTURES _I COMPLETE HEATER CESSPOOL SEPTIC TANK 42EIV �8Y® READY FOR DATE ISggOUED/ 9FIRST INSPECTIONS /moi , GAS MISCELLANEOUS � / APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB R NAME ADDRESS W M ADDRESS LOCALITY 0 A NEAREST d ,pp ¢� L CITY TEL NO CROSS ST,L10 A {y/ COUNTY m NAME/fV � ,.(iO /� A CERT NO EXPIRES LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL- I ,/ '2 ADDRESS �L�1 NORTH 0 CITY �!V TEL.NO. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION PLUMBER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ' ABOVE c� OWNER f CORRECTIONS _s o 4 ku4A SOUTH DESCRIPTION OF WORN BATH TUB FURNACE ROWER DISHWASHER w O AVATORY REFRIGERATOR VITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP �J LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING' ETER ' GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES !�® SEPTIC TANK I i CESSPOOI SEPTIC TANK SEWER Fs ITOTAL FEE �CP 4g-0 uTa1TY co NOTIFIED FINAL a D.E.S.17 FSM SETS-1-48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY 1COUNTY OF LOS ANGELES PLUMBING WM.J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT . GROUP o PERMIT O. ROUGH FIXTURES COMPLETE �- HEATER CESSPOOL -I SEPTIC TANK ECEIVED BY READY FOR FIa I RST INSPECTION � AS MISCELLANEOUSG L L� /', DATB 188U<ID -/3--490 APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB C NAME "ma:Iv ADDRESS M4 _o4�% e ��__ T";' Y ADDRE88 � �A�iL1rJ ,�,-zi4' LOCALITY fy d NEAREST a CITY y°M l _ �9.TEL No. CROSS ST. COUNTY CERT No EXPIRES m NAME LOCATION O ETI PC TANK, OR CESSPOOL 3 ADDRESS NORTH O CITY11Y 47� TEL.NO. 1 AM 'THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMSER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED A0OVE. Y 03V1 OWNER CORRECTIONS SOUTH DESCRIPTION OF WORK z BATH TUB FURNACE O !Y ROWER DISHWASHER Q _LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP FLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR 8 NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I ETER GAS SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK _.�._CESSPOOI SEPTIC TANK SEWER I UTILITY CO NOTIFIED I TOTAL FEE �`/ /' FINAL 0 76AG67 17 2SM SETS 7-48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT . GRO P o PERMIT NO. ROUGH FIXTURES COMPLETE 5 , !` /5-o HEATER CESSPOOL I—I SEPTIC TANK RECEI D READY FOR DATE ISSUED r YA FIRST INSPECTION AS M1 /ELLANEOUS '� H (/! APPLICANT FILL IN,IIEAVILY OUTLINED PORTION ONLY K NAME ,/yy t-R _ADDRESS t0 ADDRESS �J�J v, /� LOCALITY A NEAREST AC CITY /� TEL No ROBB BT. 6 COUNTY LICENSE NO EXPIRES K NAME � J LOCATION OF SEPTIC TANK, OR CESSPOOL 3 MAIL ADDRESS %L -��- NORTH O CITY TEL.No IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER CORRECTIONS - s SOUTH X97 J DESCRIPTION OF WORK i FURNACE �j j ,�j p I7 \ HATH TUB Gc 3 / �O ll 4111 9 g _ D ROWER DISHWASHER -5xo 1 1 r` O -LAVATORY REFRIGERATOR T��A-e per- KITCHEN SINK WATER SOFTENER FLOOR BINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS A ' WATER CLOSET DRINKING FOUNTAIN 6DfATE INSPECTOR'S NAME 1 WATER HEATER DENTAL LAVATORY ROUGH PLUMBING t G METER- GAS SODA FOUNTAIN OUTL Iyp9 PIPING I i GAS VENT I CESSPOOL TOTAL NUMBER OF FIXTURESSEPTIC TANK I I CESSPOOI f%EPTIC TANK SEWER S UTILITY CO NOTIFIED I TOTAL FEE � FINAL I 'r WORKERS'COMPb SATIOI`JDECLARATION APPLICATION FOR PLUMBING PERMIT 1 hereby affirm that I have a certificate of consent to self 76A667A ;^insefe,.br 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 I ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING / �� ,A/1 `C, Certified copy is filed with the county building inspec- ADDRESS tion department NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET LOCALITY J Date Appligant NEARE CROSS ST w A a CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB Dm COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL .-{ the permit is for one hundred dollars ($100)or less ) LAVATORY (/ ADDRESS �1�i 1 certify that in the performance of the work for which this U-LOar permit is issued, I shall not employ any person in any m ner SINK CITY p TEL NO JJ so as to become subject to the Workers'Compens io L s DISHWASHER i CONTRACTOR Date Applica CLOTHES WASHER NOTICE TO APPLICANT If aft making this ficate of ADDRESS Exemption, you should ec a subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions e Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be ISTATE LIC deemed revoked WATER HEATER oloLICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NC. PROCESS BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL V IDATION O DATE License Number Lic Class 11W FINAL O Contractor Date BY U I am exempt under Sec H O. B 8P C for this reason '—� Plan check fee Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Ncimi. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Address e– Professions Code) City TelRSV �3 2 Q 1 A 1, as owner of the property, will do the work and the # o o 0 o 0 5 structure is not intended or offered for sale (Section 7044, Business and Professions Code) ( o 0 3 i�5 0 CONSTRUCTION LENDING AGENCY o o o 3 IL 5 0 U I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued 1 0. 1 7-85 (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 ordinances and State laws regulating Plumbing and hereby authorize representatives of this County to enter upon the above-mentioned aper' inspection urposes SEE REVERSE FOR EXPLANATORY LANGUAGE gnature of Xr"__&U7Date