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HomeMy Public PortalAbout6149 ENCINITA AVE_Plumbing__ B^eBTAPPLICATION FOR PLUMBING PERMIT 1 �E B1 e_BUILDING AND SAFETY DMSION 1 Department of County Engineer County of Los AngelesBUILDING JOHN A. LAMBIE,COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN, SUPT OF BUILDING LOCALITY FOR PLICANT TO F L IN NEAREST / CROSS ST. OWNER DISTRICTNO. GROUP INSPECTION I READY soA INSPEcon MAIL S ADDRESS INDUSTRIAL CITY / ' ► TEL. NO. WASTE APPROVAL PLUMBER . W , INSPECTION RECORD ADD SS CITY LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ SI.00 S OO /`7- .`7 f-"; ' �• " /".0/�� �%� J BATHTUB @ $1.00t)t7 ;; SHOWER @ $1.00 1 LAVATORY (WASH BASIN) @ $1.00 - n KITCHEN SINK @ S1.00 001 1f7� ?•`�. !nnen, V .l'Y)<'.�Q'+r;l� DISHWASHER @ $1.00LAUNDRY TUB TUB OR TRAY @ $1.00 CLOTHESWASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 190 *ACF' /h/AAAin LO7 EP I/I/AF-'! { .C//✓iC [2rRcsF /a�/HAPO; n.�,'n Y7—PRPlt //P, /yly1 L4., APPROVALS LODR DATE � INSPECTOR'S ,SIGNATURE UNDER$ BWORK —I T'.SS/ �•' PERMIT S 1 00 ROUGH PLUMBING /// (�(• - _G7)'G) q GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP KATION HOT WATER HEATER—It'h ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY or AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY RS8(STEREO AND/OR GAS TEST c LICENSED AS REOUIREO Y LOS ANGELES,GOUNTY AND STATE OF CALIFORNIA OR THAT A EG MOWN �O HE ABOYE < UTILITY CO.NOTIFIED y DESCRIBED RESIDENT L ERTY. " SIGNATURE V OF PERM ITTEE FINAL ROBERT A. 00 JOHN A. LAMBIE. C / NTY ENGINEER VALIDATION SUPERVISING MECHANICAL NG•R M.o. CASH t _,C404 6— NOV 5 3 9.00 0 WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 26A667 DPW 4/B] r ' khereby, affirm.that I have o certificate of consent to self in- )6A667A '7ILJI' (jure, or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) •certified copy thereof (Sec. 3800, Lab. C:) , ' COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS. _ Pal icY No. Company Certified copy is hereby furnished. . t FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUIS TINGLD Certified copy is filed with the county building inspection ADDR (O L N I PTi department. NUMBER FIXTURE OR ITEM @ FEE /y LOCALITY G Date Applicant WATER CLOSET(TOILET) no NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' - BATH TUB O CROSS ST. COMPENSATION INSURANCESHOWER 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 I certify that in the performance of the work for which this per- SINK CITY TG TEL. NO�•� mit is issued, I shall no:employ any person in any manner so as to become.subject to the Workers'Compensation Laws. ,DISHWASHER CONTRACTOR - Date Applicant / -CLOTHES WASHER - ADDRESS NOTICE TO APPLICANT: If, after jest:a 'this Certificate of Ex- • 'SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Comport- CITY TEL NO. sedan provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM lywith such provisions or this permit shall be deemed revok- - STATE LIC. ed. .WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION - - DISTRICCT O - OCES ED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS US( 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL/// �•�, - VALIDATION a feet. DATE { Ll �� D License Number Lic. Class U FI Contractor Date - B F O W am exempt under Sec. 1 W CL B.BP.C. for this reasonPlan check fee D 2 - Dote: PLUMBING PERMIT ISSUING FEE S Signature In G - ' TOTAL FEE LJ SINGLE FAMILY Plan check applicant ' HOME OWNER-BUILDER DECLARATION _ S 1 hereby affirm that I am exempt from the Contractor's License Name - Low for the following reason (Section 7031.5, Business anda Professions Code): Address t ACICT.a 1, as.owner of the property, will do the work and the City Tel. No. 3307 .1 28.50 structure is not intended or offered for sale(Section 7044, 1 ITEMS Business and Professions Code). D - TOTAL 28.50 CONSTRUCTION LENDING AGENCY "hereby affirm that there is a construction lending agency for - CHEC.Yt 28.50' the performance of the work for which this permit is issued i• CHANGE 00 (Sec. 3097, Civ. C.). Lender's Name 0000-0001 pp9ttf�t 15/v9 Lender's Address .57321 ft112C[I] I certify that I have read this application and state that the - above information is correct. I agree to comply with all County v+ D ordinances and State laws regulating Plumbing, and hereby authori representatives f this County to enter upon the ' above- .nlioned proper for insp [ on'purposes. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Si re of Per tee Date • WORKERS shot tCOMPENSATION DECLARATION APPLICATION PPLIC A TION ICT PLUMBING mp l Eppls Ipp,p� PERMIT het Eby, affirm that I Wore certificate of consent to self ra 76A667APw 4/87 PYIr IL '�.r P'i II p\'1 Ir p'( Ir ILVpVpID OCIt9 PERMIT Y'UVp Y n sure;or o c py there of Workers'Compensation Insurance,ora CE 817(REV. 8/86) Iul - certfied'copy thereof (Sec. 3800, Lab. C_.) Polity No. Company - COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished., FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING �. Certified copy is filed with the county building inspection ADDRESS ' department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET (TOILET) Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS" ;BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER "eO (This section need not be completed if the work involved by MAIL ' the permit is for one hundred dollars,($100)ordess.) LAVATORY ADDRESS c I certify that in the performance of the work for which this per- �/ f - mit is issued, I shall not employ any'person in any manner so SINK CITY 7e,,, (Q �i N %V90"EL. NO, r6'36r-� as to becorrif su lect to'the Workers' o pensa�af DISHWASHER CONTRACTOR Date ' Applicant CLOTHES WASHER NOTICE T AP LICANT: If, ober making this C' rADDRESS you should become subject to the Workers'Com en SWIMMING POOL RECEPTOR en- tion, P Y P CITY TEL NO, cation provisions of the Labor Code, you muss forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC - ed. IWATER HEATER LICENSE NO. CLASS ' LICENSED CONTRACTORS DECLARATION DIS RICT N P CESS D I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM (;LQUTLETS 9-(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER -t fed Professions Code, and my license is in full force and et- 5 PER SYSTEM FINAL VALIDATION R _ - DATE l( 2!� , License Number Lic. Class 0 FINAL R Contractor Date BY p I am exempt.under Sec. - W CL B.BP.C. for this reason - 'e'� D W Plan check fee, � Z y Date: ( PLUMBING PERMIT ISSUING FEE $ 5 , Signature - . . TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Name AC4T.i Low for the following'reason (Section 7031.5, Business and 9p-. Professions Cade): Address. 0307 - +�+•'!LI I, as owner of the property, will da the work and the City Tel. No. .'.1 ITEMS structure is not intended or offered for sale(Section 7044, Business and Professions Code). TOTAL ifs c-�© CONSTRUCTION LENDING AGENCY • D _ CHECK 16•50 1 hereby affirm that there is a construction lending agency for 4 CHANGE the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). • , Le nder"s Nome 17000—I]O171 il/ 6J=,9 Lender's Address - Er57U 1 AM 9:34 I certify that I have read this application and state that the above information is correct. I agree to comply with all County D . ordinances and State laws regulating Plumbing, and hereby - authorize representatives of this County to enter upon the ob s mentioned pr erty for in eation purpos J( SEE REVERSE FOR EXPLANATORY LANGUAGE , i n '.Sature o # ermittee ` DolA WORKERS'COMPENSATION DECLARATION FOR PLUMBING. L AppIDBpA,/'� PERMIT 40-0047 DPW 4/87 APPLICATION If' Y'� r LJ'�VAID Ytl'♦Y r IG Y'l�M® Y n I hereby, afftrm that'I haven certificate of consent to self in- 77A667A ILfI sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/87) certified copy thereof (Sec. 3800,job. C.).: . COUNTY OF LOS ANGELES - DEPT. OF PUBLIC WORKS Policy No..K Company ' Certified copy is hereby furnished. -� FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING /"'' l- Certified copy is filed with the county building inspection ADDRESS c C/+'( / �d /]'A UP' department NUMBER FIXTURE OR ITEM. @ FEE LOCALITY ' WATER CLOSET(TOILET) 0ie Date Applicant NEAREST - CERTIFICATE OF EXEMPTION FROM WORKERS' `BATH TUB - CROSS Si. COMPENSATION INSURANCE SHOWER OWNER C�Gc-V�P✓` - (This section need not be completed if the work involved by MAIL l - the permit is for one hundred dollars ($100) or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY PM (e TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER ' 11-a 1 i ���� �� CONTRACTOR Date Applicant '� _ -�/ y CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR soti - on nyou should become subject to the Workers'Co mpen- CITY TEL. NO. cation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly withsuch provisions or this permit shall be deemed revok- STATE .LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION STRICT gJRO S av I hereby affirm that I am licensed under:provisidns of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL / n_ ALIDATION > fect. DATE Il Y�31Y 6 License Number Lic. Class- O U Contractor Date BY G O F I am exempt under Sec. - W W B.sP.c. for'this reason11. Plan check fee to z Date: PLUMBING PERMIT ISSUINGTEE S 510 Signature TOTAL FEE SINGLE FAMILY Plan check applicant - HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the•Contractor's License Nome a Law for the following'.reoson (Section 7031.5, Business and AC•GT.r ' Professions Code): Address .i3O7 16.50 0 I, as owner of the property, will do the work and the City. t Tel. No. 1 ITEMS structure isnot intended or offered for sale(Section 7044, _ Business and Professions Code). D TOTAL 16. 50 • CONSTRUCTION LENDING AGENCY CHECK 16.50 I hereby affirm that there is a construction lending agency for' t. the performance of the work for which this permit is issued CHANGE ..00 (Sec 3097, Civ. C.). - Cerider's Name _ DDOD'ODD1 11�?v>/v5 Lender's Address 7056 1 AM 8:25 -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 represeNotives of this County to enter upon the abo a entioned prtives fthisC tion purposes. -��aU SEE REVERSE FOR EXPLANATORY LANGUAGE C Signature of rm ittee Date s