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Home My Public Portal About5021 FIESTA AVE_Plumbing__ 76A667A ICE"8L7B) -477 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS '® WATER CLOSETect U LOCALITY NEA REST BATH TUBCROSS ST. S SHOWER OWNER 'a l �l LAVATORY MAIL /TLA, T ADDRESS SINK CITY. S14 TEL.NO. DISHWASHER CONTRACTOR / CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS DISTRICT NO. GROUP ZONE ROC ED BY OUTLETS OVER CD 5 PER SYSTEM INDUSTRIAL V WASTE APPROVAL INSPECTION RECORD O) v w CA z Plan check fee PLUMBING PERMIT ISSUING FEE$ ..7 ru TOTAL FEE Plan check applicant Name 1/ �'' 2,41 APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address6,,q .y ,es ROUGH PLUMBING Cit I C ` Tel.No..aX g GAS PIPING I HERE ACKNOWLEDGE TH I HAVE READ THIS APPLICATION AND STATE GAS VENT 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 LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE GAS TEST LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. /JK UTILITY CO.NOTIFIED SIGNATURE //`�.� J_ OF PERMITTE E, ,�/_Z�f'� /(�J/L•• FINAL �Ayy PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH 0 2 4 r2 JUL 31 5 U WORKERS' COMPENSATION DECLARATION 6 DPW 4/87 APPLICATION FOR PLUMBING PERMIT �t r t 4., 76A66 hereby, affirm that I have a certificate of consent to self in- 76A667A sure,.or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) ce1'tified.copy thereof (Sec. 3800, Lab. C.) Policy.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 /p' LOCALITY`J�(/LL✓✓ /,_ 67t✓� ' _ .91"/W Date Applicant WATER CLOSET(TOILET) - NEAREST [[ �y BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' a COMPENSATION INSURANCE �d OWNER / SHOWER (� L (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORYC! ADDRESS,, 7 f C \•`�(� I certify that'in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. VO (y' as to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS em tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR p y I p CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM lywith such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. CPROCESSED BY GAS SYSTEM OUTLETS I hereby affirm that I am licensed under provisions of Chapter 9.(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL l / v� _ VALIDATION DATE /J �/ O License Number Lic. Class U ' FINAL % � Contractor Date BY �fO I am exempt under Sec. 0 LU B.&P.C. for this reason ® U) Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ a Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION •Plan check applicant — I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and i+=•:• :.a Professions Code): Address e� I, as owner of the property, will do the work and theCity Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). 60 CONSTRUCTION LENDING AGENCY !''i..!C 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 1 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 abov -menti ne prop rty fr�inspection purposes. y 2r ZZSEE REVERSE FOR EXPLANATORY,LANGUAGE Signature of Permittee Date 76A667 (•CE-817) - 5/73let ' APPLICATION FOR-PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING'AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO: ADDRESS ;:>+`' �''!� •' F / % `j^ HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY.:,.-- 1;• "� FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM CROSS ST. @ FEE I WATER CLOSET 1.75 OWNER {` , „d• ��, ,P` 4�;`:1,6, t MAIL +y.. BATH TUB 1.75 ADDRESS•_ r J I fir'" ? a ✓` f t SHOWER 1,75 CITY TEL. NO._& LAVATORY 1,75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1,7S CITY TEL. NO. CLOTHES WASHER 1.75 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1,75 DISTRIXT NO. GROUP`/ ZONE ,r F..R CESSED Beyf LAWN SPRINKLER SYSTEM 1,75 —wi a'g WATER HEATER 1,75 INDUSTRIAL WASTE APPROVAL "*� •''"V GAS SYSTEM OUTLETS 1.75 i OUTLETS OVER INSPECTION RECORD •• „"� 5 PER SYSTEM .30 `:N!'j' �•Q C:) w H Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK ,.» Name rAj AlIC" �'�p ,> } /.��r�yf (r �J "� ,t ROUGH PLUMBING Address-*;-,r•:,, , f= a js- GAS PIPING Clty•` '% r Tel. No: ""'/ '�S" GAS VENT HOT WATER'HEATER I HEREBY ACKNOWLEDGE T"4T I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES , WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO..NOTIFIED ' LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND.TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL —7 SIGNATURE Fr-.t✓ 'r,• y"r, /=�KJ OF PERMITTEE •C '� �i` e e PERMIT VALIDATION �s-CK"' . M,O. ,r CASH PLAN CHECK VALIDATION CK. M.O. CASH I A; " ,,7 '; ,Ake 76A667 (CE-817) - 5/73 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: FNEAREST DING RESS HARVEY T. BRANDT, COUNTY ENGINEER ALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) SS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS SHOWER 1,75 CITY TEL. NO. LAVATORY 1.75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1,75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT N0. GROUP IZONE1 PROCESSED BY LAWN SPRINKLER SYSTEM 1.75 1" , - _ CL. WATER HEATER 1.75 INDUSTRIAL O WASTE APPROVAL v GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD � OUTLETS OVER ,30 LL. 5 PER SYSTEM C C CD Li H Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL —'3 SI G N A TU RE OF PERMITTEE PERMIT VALIDATION CK.. M.O. .�C—ASH-- PLAN CHECK VALIDATION CK. M.O. CASH f 7 1 014;0 II 76A667 (CE-817)-4/72 - APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM @ FEE CROSS ST. OWNER WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS SHOWER 1.75 CITY TEL. NO. LAVATORY 1.75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. N0. CLOTHES WASHER 1.75 STATE LIC SWIMMING POOL RECEPTOR 7.75 LICENSE NO. CLASS DISTRICT NO. GROUP ] ZONE PROCESSED BY LAWN SPRINKLER SYSTEM 1.75 ,x, WATER HEATER 1.75 INDUSTRIAL O WASTE APPROVAL C? GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD J OUTLETS OVER 30 5 PER SYSTEM CD a w Plan check fee See Reverse PLUMBING PERMIT ISSUING'FEE $ 3 Do TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE 1,n check applicant UNDER SLAB WORK ne ROUGH PLUMBING dress GAS PIPING Tel. No. GAS VENT HOT WATER HEATER HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES I. ALL COUNTY ORDINANCES AND STATE LAWS REGULATING AGING. GAS TEST HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED NSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL _ ;NATU RE )F PERMITTEE PERMIT VALIDATION CK. M.O. CASH AN CHECK VALIDATION CK. M.O. CASH