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Home My Public Portal About5702 ENCINITA AVE_Plumbing__ 76A667-CE0817 4-67 APPLI-CATI N FOR PLUMBING PERMIT COUNTY OF LOSS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONBDILDING JOHN A. LAMBIE. COUNTY ENGINEER ADD BESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCAL[ �� `�. FOR APPLICANT TO FILL IN I NEASESS7. NUMBER FIXTURE OR ITEM IEA H FEE OWNER WATER CLOSET SI 5 MAIL BATH TUB I 1 5 ADDRES SHOWER 1 5 cl TEL N LAVATORY 1 5 CONTAAC SINK 25 ADDRES911-9 DISHWASHER 1.25 C TEL. NOI STATE LIC LAUNDRY TUB 1 05 LICENSE N CLASS CLOTHES WASHER 1 5 DI�LRICT NO. GRO Z�E P O E ED BY 11 WATER HEATER I.50 jGAS SYSTEM OUTLETS 1'50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .00 fNSPECTION RECORD d CD �. �' T C. Iflat- " 0 I I I d I APPROVALS DATE INSPECTOR S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL C011HTY ORDINANCES AND STATE LAWS REGULATING MOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR 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 RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE -FINAL f VALIDATION JACK R. ALLEN cnsH SUPERVISING MECHANICAL ENG-R. 3 16 0Q FEB19 5 D 23:5.0~ Wfirm that COMPENSATION a ATION DECLARATION APPLICATION ®Imp IC p TIOlap IC®® ®p p Ilpp BI IAAF! I�EIDMIT I hereby;affirm that I have a certificate of consent to self in- jbA�jA�4/� P91r Ir lL rbP9 p ,p.V Ir Ill Ir IL�Yy9M! IIBv� PERMIT II �l -sure,ora certificate of Workers.Compensation Insurance,ora S I certified copy thereof (Sec. 3800, Lab. C.) - - lul Policy N013iJ6l3 _Company S�lrTG I=uNO F COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS g?.Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS F NUMBER FIXTURE OR ITEM EE LOCALITY department. O° ✓ WATER CLOSET(TOILET) Dote _3_ Applicant ! a �'i r�uJa ) r�G •NEARESTT. .l7d L g CERTIFICATE OF EXEMPTION FROM WORKERS'. (. BATHTUB ' COMPENSATION INSURANCEr SHOWER OWNER (This section need not be completed if the work involved by MAIL - the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 6"/0.;7_ ! Cl N I 1 V 1�rJ!^ I certify that in the performance of the work for which this per- { mit is issued, I shall not employ any person in any manner so SINK - CtiVrL_ /La Cr l TEL. NO. as to become subject to the Workers' Compensation Laws. DISHWASHER CONTRACTOR �� )� ��/Q,L 4-- Date—Applicant —Date Applicant CLOTHES WASHER ADDRESS a (o G�.�. NOTICE TO APPLICANT: If, after making this Certificate of Ex- �H'SOsF 5 em tion,y I P SWIMMING POOL RECEPTOR Ex- emption,you should become subject to the Workers' th c en, - CITY .7 TEL NO. r sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS J�lO FI /!!}x2 ly with such provisions or this permit shall be deemed revok- STATE -DC. //qq ed. - - WATER HEATER LICENSE NO, 6-7,2.X / 5 CLASS hl— LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS J's Gp 9(commencing with Section 70en 00)of Division 3 of the Business - OUTLETS OVER `�' and Professions Code, and my license is in full force and of-. 5 PER SYSTEM FINAL // VALIDATION fect. p HOSE BIB DATE /J— 6 . 6 License Numi7�a / `J Lic..�loss FINAL O Contractor` — �'/ r'" BY U ate O I.am exempt under Sec. V B.&P.C. for this reason ® 6 Plan check fee W Date: PLUMBING PERMIT ISSUING FEE$ O 2 Signature TOTAL FEE �a c SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION Plan check-applicant' ACCT.a I hereby affirm that I am exempt from the Contractor's License Name91.7D Law for the following reason (Section 7031.5, .Business and 330J Professions Code): - Address 1 ITEMS I, asowner of the property, y will do the work and the Cit - Tel. No. structure isnot intended ar offered for sale(Section 7044, , TOTAL c �� Business and Professions Code). - CHECK 91.110 _CONSTRUCTION LENDING AGENCY ® CHANGE .00 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec'3097, Civ. C.). ' 0000-0001 41 5/96 Lender's Name 5721 1,. AN 9:30 Lender's Address I certify that I hoveread this a kation and state that the above information is come I a ree tdtcomply with all County ordinances nd State la s e lacing lumbing, and hereby authorize es niati s f his Co ty to enter upon the „ obov - n io ed prop rt f ins ction purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signefu're 94 Permi)+W Date , W RS'COMPENSATIONDECLARATION APPLICATION FOR PLUMBING PERMIT I hereby,affirm that I have a certificate of consent to self 76A887A insure, or a certificate of Workers'Compensation Insurance, CE 817 (REV. 8/88) or a certified copy thereof (Sec. 3800, Lab, C.) Policy No. Company woe IL, #e T COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING QJrq .Certified copy is filed with the county building inspec- ADDRESS /�1' 4 ✓ /1el;ILe tion department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY . Date AppliSant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed II the work Involved by SHOWER r 'the permit Is for one hundred dollars ($100)or less.) LAVATORY MAR r ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY • Gm 1 TEL. NO. / so as to become subject to the Workers'Compensation Lows. DISHWASHER - CONTRACTO Date Applicant ' CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS3o.,2 ;t— AZ AILsc,'0�4rsr Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY _ TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE �/f / LIC. deemed revoked. WATER HEATER LICENSE NO. wp CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO., i/ PROCESSED I hereby off irm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER y and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL /, _ LIDATION U License Number Lic. Class - Av � Q i FIN O Contractor Date - B ~ U ❑' 1 am exempt under Sec. - d N B.BP.C. for this reason_ Plan Check fee Date: PLUMBING PERMIT ISSUING FEE$ ' Signature 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 $ 2, ] a Law for,the following reason (Section 7031.5, Business and Professions Code): City Tel. No. '$Fre e o are 5 ❑ 1, as owner of the property, will do the work and the '( e e 1 650 structure is not intended or offered far sale (Section D - 7044, Business and Professions Code). ;e o e ) 65 Q CONSTRUCTION LENDING AGENCY - 9,S Q $7 I hereby affirm 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 _ 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-mentioned operty r inspection purposes. L � SEE REVERSE FOR EXPLANATORY LANGUAGE . ✓/ 9 Io Signatur of Perm lee D WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby,affirm that I have a certificate of consent to self 76A667A ✓IILJII insure, or a certificate of Workers' Compensation Insurance, CE 817 (REV. 8/86) - or a certified copy thereof (Sec. 3800, Lob. C.) r� ��,,�� LL//�� / COUNTY OF LOS ANGELES ,DEPT. OF��PUBLIC WORKS Policy No.LClp-li t.1 �ompony Z-?'n!-�4 .'li s �,• _ a Certified copy is hereby furnished. t FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING \^ �\ �\t Imo' Certified copy is filed with the county building inspec- ADDRESS �J /C/d— , \ ' L� hon deport ment. NUMBER FIXTURE OR ITEM @ FEE t LOCALITY 4 Date /"_ - Appli4ant WATER CLOSET�""' NEAREST , ` •5 t CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. >- COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER Cl'l'i-ko mcy\`('1T'o MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS S h -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•\ so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR C Date Applicant - CLOTHESWASHER - ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' - Compensation.provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY S f� TEL. NO.S _ j with comply with such provisions or this permit shall be STATE ✓'�'� L LIC. n deemed-revoked. - WATER HEATER LICENSE.NO.L' CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NOPROUSSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS c UOy (commencing with Section'7000) of Division of the Business - OUTLETS OVERIr and Professions Code, and my license is in full force atndeffed; 5 PER SYSTEM FINAL �./// O VALID ON O Ir/,�� 'L ,., S IC x s K DATE 6 G W AA License NumberJ�..1L�J---Lic Class_��"i`6L .F,- tel o ContractorQY1'T Data )�' 0`� ❑ :.8930 0 I am exempt under Sec. p� /+ �. o o $�15 6 B.BP.C. for this reasonPP Plan check fele ed er D n a a4Q505 ? Date 0 2 0 8''.•8 8 S r ; 1,ka_Yfl� - PLUMBING PERMIT ISSUING FEE$ 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 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm 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 - Lenders Address I certify that I have read this application and state that the D . above information is correct. 1 agree to comply with all County - ordinances and State lows regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE.. Signature of Permittee Date , 1 WORKER'S have a certificate of consent to 260026 DPW 9/89 APPLICATION FOR PLUMBING PERMIT lJ 0A026 ''I hereby affirm that I have a Certificate of consent to self insure, or ;.certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec.3800 Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. Policy Na. Company ❑ Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(POINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. - NUMBER FIXTURE OR ITEM ® FEE LOCALITYCI C Date Applicant WATER CLOSET /r/ NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. BATH TUB ASSESSOR COMPENSATION INSURANCE MAP BOOK PAGE PARCEL (This section need not be completed If the work Involved by the SHOWER permit is for one hundred dollars($100)or less.) LAVATORY OWNER Sch/ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as toSINK MAIL ^ O� become subject to the Workers'Compensation.Laws. ADDRESS J ejvC p 916/i. DISWASHER CITY LI TEL.NO.(1/ Date Applicant CLOTHES WASHER bb NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR - Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER d (commencing with Section 7000) of Division 3 of the Business and STATE LIC. GAS SYSTEM OUTLETS LICENSE Professions Code, and my license is in full force and effect. DIS CLASS („) OUTLETS OVER DISTRICT NO. p PROCESSED BV [[ 5 PER SYSTEM r, O License Number Lic.Class 1� q ..__ y V FINAL VAUVAfiION LU DATE d Contractor Date ' h-' -'7•'�=l fA F1 #Val I am exempt under Sec. 4FIN AL I ITEMSB.BP.C.for this reason Plan check fee TOTAL AL 57 _ .tet] .� Date: ("7 �{tl_�� .``17,111 Signature PLUMBING PERMIT ISSUING FEE$ g CHANGE ili l ❑ TOTAL FEE 7 SINGPlan check applicant 13Q1J-)J00 71�';'Pi-'� HOME OWNER-BUILDER UILDER DE DECLARATION Name � _ I hereby affirm that I am exempt from the Contractor's License Law b995 �( for the following reason (Section 7031.5, Business and Professions Address 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 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned fD—efoL11p.ff?MEpurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee Date I