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Home My Public Portal About9861 FLAHERTY ST_Plumbing__ 76A667 (CE-817( - 1/75 APPLICATION F 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 .-, 12g- T FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER ��.= 7 SO WATER CLOSET 00 BATH TUB 00 MAIL / ADDRESS — SHOWER - 00 CITY l3/�P` : TEL. NO. LAVATORY .00 CONTRACTOR / /of -- f SINK f .00 ADDRESS �v/�� / L� DISHWASHER .00 CITY r, / �A` TEL. NO.g 7✓ j CLOTHES WASHER [2.00 STATE - ,K7 :5-6 / LIC LICENSE NO.�(�j (p P CLASS a� SWIMMING POOL RECEPTOR DISTRICT NO.GROUP ONE PR CESSE BY LAWN SPRINKLER SYSTEM �Dg i WATER HEATER INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2.00 j INSPECTION RECORD 0 OUTLETS OVER 30 U 5 PER SYSTEM O I--- U W a N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'SSIGNATURE Plan check applicant UNDER SLAB WORK 17-12-26 12n Nagle ROUGH PLUMBING ita�S (W Address , GAS PIPING City Tel..No. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ •THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT AM H C)EGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOV DES CRIB D ESIDENTIALr PAq ERTY. FINAL "11G3URE URE T E PERMIT VA IDA ION OCK .O. CASH PLAN CHECK VALIDATION CK. M.O. CASH J �%/ 12 JuL 1 5 D 1 1.7 5 ,,11 s 76A667-CEu817 6-65 APPLICATION FOR PLUMBING PERMI_ COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W JENKINS SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER _ WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR SINN 1.25 ADDRESS DISHWASHER 1.25 CITY s TE O. STATELI LIC S, TUB 1.25 LICENSE NO CLASS CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PRO ESS BY WATER HEATER 1.50 �� (, � /� , } GAS SYSTEM—OUTLETS--*150 INDUSTRIAL a WASTE APPROVAL Q OUTLETS OVER 5 PER SYSTEM .30 / INSPECTION RECORD U. Q L W CL N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK _ ROUGH PLUMBING TOTAL FEE O GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 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 I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERT UTILITY CO. NOTIFIED SIGNATURE L" OF PERMITTEE— -7r FINAL � LIDATION CK. M O. CASH �% 2586- �P� 8 5 D 6.50~ kAl i} WORKERS' COMPENSATION DECLARATION ' APPLICATION FOR PLUMBING4P_ E,RMIT* I hereby,,affirm thotd have a certificate of consent fo;self in 20-0026 DPW 4'/B7 •' 76A667A • •' _ .. . sure,or a certificate of Workers'Compensation Insurance;,or a' CE 817(REV 8%86), -, c rhifjed copy thereof (Sec. 3800, La ��r,,��'^ COUNTY. OF LOS ANGELES DEPT-. OF_PUBLIC WORKS- P e�!�D"l:.e �-Compan Certified copy is hereby furnished' `• FOR APPLICANT TO-FILL IN•(PRINT OR TYPE) ,• BUILDING - f1` Certrfied copy is filed with the county building inspection,':`: ADDRESS L dd"epartment NUMBER FIXTURE OR,ITEM @ FEE _ t• _ - LOCALITY - _ Date' Applicant WATER CLOSET(TOILET). NEAREST CERTIFICATE OF EXEMPTION FROM WORK S" 'BATH TUB CROSS'Si COMPENSATION"INSURANCE pWNER SHOWER - - (This section need not be completed if the work involved,by MAIL the permit-is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of'the wd�.k,for which this per- mit is issued,-I shall"hot employ;any person in any manner so SINK - ; CITY• TEL NO� as to`become subject to:the Workers'Compensation Laws' DISHWASHER a CONTRACTOR Date' Applicant y` CLOTHES WASHER_ ADDRESS t'•, NOTICE TO:APPLICANT 'If, afier'makirig this•Certificate of Ex- SWIMMING•POOL•RECEPTOR "' emphon,you should become.subject,to'the•Workers'Compen- CITY TEL NO sation provisions of the.Lab'or-Code,"you must forthwith comp- -LAWN SPRINKLER SYSTEM ?' ly jr- with such'provisions or this permit shall,be deemed revok- STATE LIC { • ed:" WATER HEATER - O LICENSE NO" " :CLAS �•; LICENSED.CONTRACTORS DECLARATION DISTRICT NO ROCESSED,BY - -I hereby affirm that I am hcensed under provisions of-Chapter GAS SYSTEM. OUTLETS 9(commencing with Section 7000)of Division S of.the Business OUTLETS OVER d and Professions.Code, and my license is in full force and ef- 5 PER SYSTEM FINAL. VALIDATION >' fect DATEa' �` -'' d License Number c_CI-ass O •FINALJfContractate �/ BY - ; O El 1•6m.exempt.under c r5 �" b W B &P C. for this reason ► _ y Plan check fee Date. PLUMBING PERMIT,ISSUING FEE$ w &0 �::`• Signature 'TOTAL FEE 0/f� 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 d5,- Business and " ` tiyL•i o8 Professions Code): Address ( - u { �d4.;t' .as:owner of the, will do the`.work and the . City: "'_ Tel .No' f'°— structure is not intended.or offered for'sole.(Section 7044, Business and Professions,Cod +�- e) 4 ' ; I(j t �0 a 50 y �i_ ' , CONSTRUCTION LENDING AGENCY =i I hereby•offirrn that there�is a construction•lending agency for, s• ' ' q �r{r, the performance of the work for,which'this permit is-issued (Sec 3097, Giv G ). . Lens-Name der' • _ • 1. - , - e I': �.tS—:j'IIS .;,• C ,b «' � ' - . r••'.., .,�� 4 ice., 'Lender',s'Address J certify,that I lia0e read this application and stateethat the ,. above information is correct I agree to c •ply with•all County ordinances and'State jaws regulating tubing, and hereby aut r.1 rep�ese1 tativ" f this Co y to,enter upon.the ab v mentioned pro erty r nspec on purposes: A SEE REVERSE FOR EXPLANATORY LANGUAGE t• Signat r of Permittee Date ` :