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HomeMy Public PortalAbout9521 FLAHERTY ST_Plumbing__ 7BA897 17 9 so ' APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUP I ZONE PERMIT NO PLUMBER W''•TE'`BO I 1 ONI BROS 1 'NC RECEIVED BY READY FOR DATE ISSUED 1112 WESTMINSTER AVE HA""\ FIRST INSPECTION 'G6- a- 6—1 ADDRESS BUILDING J r CITY TEL NO ADDRESu. ^_ 9524--SAM RT:Y, STS COUNTY LOCALITY LICENSE NO ' I 'w EXPIRES NEAREST PERM FEES CROSS ST 'rVP. E n!e , St;V.. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER p MAIL q WATER CLOSET (TOILET) @ O Sol$ I ADDRESS 3S A 6 Q, BATH TUB @ O 50.1 1 501 CITY APCAh jA 3 CAI, JP.. TEL NO SHOWER @ O 50C,�.1_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ O 501 n APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50C STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50 ANGELE COU Y LIC SE R I AM T E LEGAL OWNER OFT IA OP Y D R D ABOVE GPS SYSTEM_�_OUTLETS Q 0 50 I Iz SI A E O WATER HEATER @ O Sol =11 PERMITTEE SLOP SINK Q o so NSPECTION RECORD FLOOR SINK @ O Sol FLOOR DRAIN Q O Sol 1 DISHWASHER Q O 501 +t ry j DRINKING FOUNTAIN @ O Sol I �I��7rN tK k7 ! n W '� IURINAL nrt O 50I J HOUSE SEWER @ O 5o I Q Z MISCELLANEOUS1 1 5 O �I APPROVALS 1 DATE INSPECTORS NAME y ROUGH PLUMBING -/"�� f Zi..! GAS PIPING GAS VENT Z CESSPOOL @ 1 00 I CESSPOOL L SEPTIC TANK 1 SEPTIC TANK I DRAIN ( ) PIT ( ) Q 1 00I SEWER PERMIT 1 OO GAS TEST —i>? UTILITY CO NOTIFIED -1 ,(J TOTAL FEE $ S CJI} I vNo FINAL 76 A 667 - CE 817 7-69 � � I APPLICATION FOR PL'UMBIN PERMIT - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER _ BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS COLEMAN W JENKINS SUP T OF BUILDING LOCALITY L x Y FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM EACH j FEE OWNER r WATER CLOSET 4(` 150 MAIL BATH TUB 1 50 ADDRESS 95-2- 1 SHOWER 1 50 CITY �- TEL NO LAVATORY 1 50 CONTRACTOR SINK I 1 50 ADDRESS c? So DISHWASHER 1 50 CITY STATE [j / TEL NO �O �S �j CLOTHES WASHER j 1 50 17 a LICENSE NO / Y CLASLIC S 5C Za C.3te e SWIMMING POOL RECEPTOR 1 50 DISTRICT NO GROUP40;N�E ESSED BY 2 LAWN SPRINKLER SYSTEM 2 00 WATER HEATER 1 50 INDUSTRIAL a WASTE APPROVAL O / GAS SYSTEM OUTLETS 1 50 5-d INSPECTION RECORD tj OUTLETS OVER, 30 Z 5 PER SYSTEM O y V i O.W N Z 1 a j Plan check fee 25% of above See reverse PLUMBING PERMIT ISSUING FEE 9 2 00 TOTAL FEE APPROVALS DATE INSPECTOR SSIGNATURE Plan check applicant H UNDER SLAB WORK r Name ROUGH PLUMBING +4/"..7 Q 97 9" Address s GAS PIPING GAS VENT City Tel NO HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES 9w AND WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING I I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS 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 PROP V FINAL SIGNATURE ,�aNJ� JACK R ALLEN SU PERVISI HANICAL ENG R OF PERMITTEE ?A/elj PERMIT VALIDATIO cK M o CASH PLAN CHECK VALIDATION CK M o CASH s !-Ar,5"1210 79 JA 3 5.00' i 4 I W 20-0026 DPW 4/90 ORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT � I horeby, afQrm'that I have a certificate of consent to self in- 76A667A sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec.cc�8/00, Lab. C.) / Policy Noeb� -�T g C.�oP4�pany sdl. �/ COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy'is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE _ LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS certify that in the performance of the work for which this per- SINK CITY ' TEL. N mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTO Date Applicant CLOTHES WASHER �� � ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR ,. emption,you should become subject to the Workers'Compen- TEL. NO �5-_ sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE O LIC. ed. WATER HEATER LICENSE NO. O © CLASS C . . . . LICENSED CONTRACTORS DECLARATION DISTRICT NO. DROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 1 5 PER SYSTEM FINAL DATION fect. HOSE BIB DATE '�1"� L 43.40� License Number"e- Lic. Class IL T� FINAL 1 ITEMS 0 Contractor%w_/ � a� Date Z BY TOTAL 43 40 1 am exempt under Sec. CHECK 43.40 V B.BP.C. for this reason Plan check fee ► CHANGE .000. Date: PLUMBING PERMIT ISSUING FEE$ g Signature TOTAL FEE p 0000-0001 6/12/96 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant 6858 1 Ali 9=17 1 hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.-5,'Business and Professions Code): Address ❑ 1, as owner of the property, will do the work and the City Tel. No. 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 pJ this County to enter upon the above- io ed proper r inspection purposes. Z SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ol Permittee Date ION WORKER'S I have a certificate of consent to 76A666DP.W9/89 APPLICATION FOR PLUMBING PERMIT 76A667A I hereby affirm that I have a certificate of consent to self insure, or a 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 No. Company Certified copy is hereby furnished. BUILDING '7 FOR APPLICANT TO FILL IN(PRINT OR TYPE)❑ ADDRESS Certified copy is filed with the county building inspection "`I department. NUMBER FIXTURE OR ITEM p FEE LOCALITY � Date Applicant one WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. �l _ COMPENSATION INSURANCE MAP BOSOROK ,� PAGED PARCELv/�Y (This section need not be completed if the work involved by the one SHOWER permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY7- is issued, I shall not employ any person in any manner so as toMAIL SINK ADDRESS become subject to the Workers' Compensation Laws. DISWASHER CITY TEL.NO. Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR' Exemption, you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. �- I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE LIC. (commencing with Section 7000) of Division 3 of the Business and LICENSE NO- CLASS Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS j- PROCESSED (� OUTLETS OVER DISTRICT NO. C=� BY 5 PER SYSTEM License Number Lic.Class �'°� FINAL DATE ..<./ 'J VALIDATION W Contractor Date /// wf.�r a C0 ❑ I am exempt under Sec. BIL Y AL ACC� 0 4 B.&P.C.for this reason 3307 68.413 Plan check fee , I�� , Date: f's g PLUMBING PERMIT ISSUING FEE$ � (;ITAL 687m 40Si nature r_1TOTAL FEE r CASH Plan check applicant CASH L��.4 r SINGLE FAMILY CHANGE 'I11-1 HOME OWNER-BUILDER DECLARATION Name Molly Dougherty G I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address 9 ag er y c Code): 011011-CICID1 11/16/x' atyTemple City,Cao Tel. No. 287_3445 22 rq I,as owner of the property,will do the work and the structure sstclJey iAM 9e 14 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 regul ing Plumbing, and hereby authorize represent Ives of thi o nt Fer upon the above-mentioned /prop _ins pup es SEE REVERSE FOR EXPLANATORY LANGUAGE 1-16-92 Signature of a tnittee f Date