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HomeMy Public PortalAbout9515 FLAHERTY ST_Plumbing__ 78AtV7 CE718 S'7 5/63 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION fNEARES��ILDING JOHN A LAMBIE COUNTY ENGINEER DDRESS xef WILLIAM A JENSEN Sup r OF BUILDING OCALITY FOR APPLICANT TO FILL IN ROSS NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $125 MAILn BATH TUB 125 ADDRESS �� .Y SHOWER I Z5 CITY TEL NO LAVATORY 125 CONTRACT SINS 1 ADDRESS DISHWASHER 125 CITY TEL NO CO CTOR S / STATE LAUNDRY TUB 125 REGISTRATION NO / ��[5- COUNTY p CLOTHES WASHER 125 DICT N'q GROUP ZONE PROC7gSSED BY WATER HEATER 150 GAS SYSTEMOUTLETS 150 INDUSTRIAL a WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM 30 V INSPECTION RECORD 1 � O H a N Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2 1,00 UNDER SLAB WORK ROUGH PLUMBING Av TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER 1 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 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE D RIBED RESIDENT AL PR Y UTILITY CO NOTIFIED SIGNATURE OF PERMITTE FINAL LIDATION ROBERT A WOOD cl_cK Mlo CASH SUPERVISING MECHANICAL ENG R E Lr'il,o 1 4 3 703 OCT 15 5 D 8.5 0- � � 4 7eASS7 17 5 50 0 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY L 6 COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICkNO GROUP ZONE PERMIT NO PLUMBER WINTERBOTTOI41 DA E SSD RECEIVED BY READY FOR DATE ISSUED LIR-41A � FIRST INSPECTION r� 131 WESTMINSTER AVE 7 ADDRESS IV tiK BUILro,, CITY TEL NO ADDRESS , +- 96 L5,.FLAHERTY. ST. COUNTY _ _ LOCALITY LICENSE NO EXPIRES NEAREST PERMIT FEES CROSS ST True, E C ITY BLVD. NUMBER I TYPE OF FIXTURE OR ITEM FEE OWNER MEEKER LAND CO MAIL WATER CLOSET (TOILET) @ O 50 Is 50 ADDRESS _ BATH TUB @ O 50 I 50 CITY ARCAD I A, CAL 1 F. TEL NO SHOWER @ O 50 s o 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASHBASIN) @ O 50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATI G PLUMBING KITCHEN SINK @ O 50 50 I CERTIFY THAT Of. POPIESS THE JMOVE VALID LOS LAUNDRY TUB OR TRAY Q O 50I �0_ OF TE COUYI PRN RT O E ��GA OWNER GAS SYSTEM OUTLETS @ O S01 50 SIG WATER HEATER @ O 50 I PERMITTEE_ SLOP SINK @ 0 50 I INSPECTION RECORD FLOOR SINK @ O 501 1 FLOOR DRAIN (@ O 50I DISHWASHER @ O 5014 DRINKING FOUNTAIN @ O 50 URINAL @ O 50 "�©.�—� 04th, RA PLAIG HOUSESEWER Q O 501 Q MISCELLANEOUS I (� \ APPROVALS \ DAT��E11 �J INSPECTOR S NAME 1 ROUGH PLUMBING t v GAS PIPING -- GAS VENT CESSPOOL @ 1 00 I CESSPOOL SEPTIC TANK I SEPTIC TANK I DRAIN ( ) PIT ( ) @ 1 00I SEWER / PERMIT 1 00 GAS TEST UTILITY CO NOTIFIED t� R�J49YJi/11 TOTAL FEF I $ 5 QQ FINAL 9 7BA667A Cf 817(REf 6/78) ®S APPLIC O V- P4LWG PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST SHOWER OWNER ) LAVATORY MAIL ADDRESS SINK CITY TEL DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL N LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES GASTEST Plan check fee UTILITYCO NOTIFIED c� PLUMBING PERMIT ISSUING FEE$ j4M a TOTAL FEE FINAL Plan check applicant PLAN CHECK VA N Name Address ' City Tel No :295 1 9 A I HEREBYOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE # O O O O O 5 THAT THE ABO E IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION a oQ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT�I AM THE O O O O O LEGAL OWNER'OF D INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL U PROPERTY 1 SIGNATURE 0325-80 OFPERMI DISTEL�T NO PROCESSED BY A r INDUSTRIAL 1 WASTE APPROVAL I I WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby,affirm that I have a certificate of consent to self 78A887A ri I insure or a certificate of Workers Compensation Insurance CE 817(REV 8/88) ILII or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS PPal'cy^No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec ADDRESS G r E tion department y NUMBER FIXTURE OR ITEM FEE LOCALITY Date AppliSont r WATER CLOSET 16 NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST P 7 a COMPENSATION INSURANCE SHOWER OWNER P V L L— 4� (This section need not be completed if the work Involved by the permit is for one hundred dollars ($100)or less) MAIL / LAVATORY ADDRESS S C , L_ 5 I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner SINK CITY TEL NO._)_ S so as to become subject to the Workers Compensation Laws DISHWASH CONTRACTOR Date pplica CLOTHES WASHER ADDRESS NOTICE O APP ICANT If after m ung this Certificate of SWIMMING POOL RECEPTOR µ Exemption you should becomes blect to the Workers CITY TEL NO Compensation provisions of the Labor Code you must forth LAWN SPRINKLER SYSTEM b with comply with such provisions or this permit shall be STATE LIC- deemed Cdeemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETSd (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 15— and Professions Code and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION O License Number Lic Class _ DATE&�✓� -cc FI 0 Contractor Date B ❑ t W I am exempt under Sec y B 8P C for this reason Z - Plan check fee Signature Date i PLUMBING PERMIT ISSUING FEE$ ' r TOTAL FEE SINGLE FAMILY Plan check applicant 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 ;2 7,3 Q 8 R 7044 Business and Professions Code) # 0 0 0 0 05 CONSTRUCTION LENDING AGENCY _ 0 0 2 a 5 0 I hereby affirm that there is a construction lending agency for + the performance of the work for which this permit is issued — o 0+0 28,5 0 5: - (Sec 3097 Civ C ) , t r 0623-8w7 Lender s Name Lender s Address I certify that I have read this application and state that the + t 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 property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE i s S S nature of Permittee Date